REVIEW  PARATHYROID IMAGING Free access

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2023 June;67(2):130-7

DOI: 10.23736/S1824-4785.23.03514-8

Copyright © 2023 EDIZIONI MINERVA MEDICA

lingua: Inglese

[18F]F-Choline PET/CT and 4D-CT in the evaluation of primary hyperparathyroidism: rivals or allies?

Francesco FIZ ¹ ✉, Gianluca BOTTONI ¹, Michela MASSOLLO ¹, Pierpaolo TRIMBOLI ^{2, 3}, Ugo CATRAMBONE ⁴, Lorenzo BACIGALUPO ⁵, Sergio RIGHI ⁶, Giorgio TREGLIA ^{3, 7, 8}, Alessio IMPERIALE ^{9, 10}, Arnoldo PICCARDO ¹

¹ Department of Nuclear Medicine, Ospedali Galliera, Genoa, Italy; ² Clinic of Endocrinology and Diabetology, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; ³ Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; ⁴ Department of General and Endocrine Surgery, Ospedali Galliera, Genoa, Italy; ⁵ Department of Radiology, Ospedali Galliera, Genoa, Italy; ⁶ Department of Medical Physics, Ospedali Galliera, Genoa, Italy; ⁷ Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; ⁸ Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland; ⁹ Department of Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg University Hospitals, Strasbourg, France; ¹⁰ Department of Radiobiology, Hadrontherapy and Molecular Imaging (DRHIM), IPHC, UMR-7178, CNRS/Unistra, Strasbourg, France

Primary hyperparathyroidism is a hard-to-diagnose condition that can run without symptoms for many years without causing symptoms; yet, it can cause dire long-term consequences, such as osteoporosis and renal impairment. First-line diagnostic methods include ultrasound and parathyroid scintigraphy, which provide unsatisfactory results in terms of detection rate. Second-line imaging methods include [¹⁸F]F-Choline PET/CT, 4D-CT, and their combination. These methods have shown a great detection rate and sensitivity; however, they are to this day less widespread than the first-line ones. Both the two methods (PET and 4D-CT) have their specific advantages and field of application, as well as their specific limitations. In this narrative review, we will describe the advantages and disadvantages of the two techniques extensively. Moreover, we will try to identify whether the combined examination can play a role and how relevant this role is. Finally, we will try to define the specific clinical situation in which each method can provide the best contribution to diagnosing parathyroid tissue hyperfunction.

KEY WORDS: Positron emission tomography computed tomography; Four-Dimensional Computed Tomography; Fluoromethylcholine; Hyperparathyroidism, primary; Diagnostic imaging