EP237 - ECE_3124 - 18F-Fluorocholine positron emission tomography/computed tomography (18F-Choline PET/CT) in localization of parathyroid adenomas: a case series
Abstract
Primary hyperparathyroidism (PHPT) is a common endocrine disease, most frequently caused by solitary parathyroid adenoma. Diagnosis is established biochemically, and surgical removal of hyperfunctioning parathyroid gland is the only curative treatment. Accurate localization is therefore essential for the success of minimally invasive parathyroidectomy (MIP). Although conventional imaging modalities are effective in most cases, they yield negative or discordant results in approximately 10%-15% of cases. 18F-Fluorocholine positron emission tomography/computed tomography (18F-Choline PET/CT) is a promising advanced imaging technique demonstrating high sensitivity and positive predictive value in the detection of parathyroid adenomas. Herein, we report the results of 18F-Choline PET/CT in a case series of nine patients (N = 9) with PHPT following negative or inconclusive preoperative imaging.
18F-Choline PET/CT was performed at our hospital from 2023 to 2025. The mean age of the nine patients was 58 years old, and the female-to-male ratio was 7:2. All patients had previously undergone neck ultrasound, 6/ 9 had Sestamibi scintigraphy (99mTc-Sestamibi), 3/9 had 99mTc-Sestamibi SPECT/CT, 6/9 had 4D/CT and 1/9 had ΜRI.
18F-Choline PET/CT was positive in six out of nine patients (6/9), revealing parathyroid adenoma. All six patients had mild hypercalcemia (mean serum calcium: 11 mg/dl) and an average parathyroid hormone (PTH) of 147 pg/ml. In 2/6 patients all conventional imaging…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 9 participants or records.
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