Horm Metab Res 2010; 42(3): 209-214
DOI: 10.1055/s-0029-1243185
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

C-11 Methionine Positron Emission Tomography/Computed Tomography Localizes Parathyroid Adenomas in Primary Hyperparathyroidism

T. Weber1 , G. Cammerer1 , C. Schick2 , C. Solbach2 , A. Hillenbrand1 , T. F. Barth3 , D. Henne-Bruns1 , R. Blagieva4 , B. O. Böhm4 , S. N. Reske2 , M. Luster2
  • 1Department of Surgery, University Medical Center, Ulm, Germany
  • 2Department of Nuclear Medicine, University Medical Center, Ulm, Germany
  • 3Department of Pathology, University Medical Center, Ulm, Germany
  • 4Department of Internal Medicine, Division of Endocrinology, University Medical Center, Ulm, Germany
Further Information

Publication History

received 31.08.2009

accepted 03.11.2009

Publication Date:
14 December 2009 (online)

Abstract

In patients with primary hyperparathyroidism (pHPT), positive preoperative localization studies enable to perform a minimally invasive approach for parathyroid surgery. However, current imaging techniques are not always successful. We therefore conducted a study to determine the sensitivity of C-11 methionine positron emission tomography/computed tomography (Met-PET/CT) in localizing parathyroid adenomas in pHPT. Met-PET/CT scans of the neck and mediastinum of 33 patients undergoing parathyroidectomy for primary HPT were compared with intraoperative and histological findings. Primary HPT was caused by a single gland adenoma in 30 patients, while another 3 patients had multiglandular disease. Met-PET/CT scan correctly located a single gland adenoma in 25 out of 30 (83%) patients with pHPT, among them 2 patients with persistent disease, 7 patients with prior neck surgery, and 8 patients with concomitant thyroid nodules. In 3 patients with multiglandular disease, Met-PET/CT showed only one enlarged parathyroid gland in two individuals and was negative in the third patient. Statistical analysis found a significant correlation between true-positive results and the weight (2.42±4.05 g) and diameter (2.0±1.18 cm) of parathyroid adenomas while the subgroup with false negative findings had significantly smaller (0.98±0.54 cm) and lighter (0.5±0.38 g) glands. Sensitivity was 83% for single gland adenomas and 67% for multiglandular disease. Met-PET/CT correctly localized 83% of single gland parathyroid adenomas in patients with pHPT. However, preoperative localization of multiglandular disease due to double adenomas or parathyroid hyperplasia remained difficult.

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Correspondence

Prof. Dr. T. Weber

Department of Surgery

University Hospital Ulm

Steinhoevelstraße 9

89075 Ulm

Germany

Phone: +49 731 500 53610

Fax: +49 731 500 53503

Email: theresia.weber@uniklinik-ulm.de