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. 2011 Oct 10;2(10):348-54.
doi: 10.5306/wjco.v2.i10.348.

FDG-PET/CT and parathyroid carcinoma: Review of literature and illustrative case series

Laura Evangelista  1 , Nadia Sorgato, Francesca Torresan, Isabella Merante Boschin, Gianmaria Pennelli, Giorgio Saladini, Andrea Piotto, Domenico Rubello, Maria Rosa Pelizzo
Affiliations

FDG-PET/CT and parathyroid carcinoma: Review of literature and illustrative case series

Laura Evangelista et al. World J Clin Oncol. .

Abstract

Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis. The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatment. The role of positron emission tomography/computed tomography (PET/CT) with 18F-Fluorodeoxyglucose (18F-FDG) as an imaging tool in parathyroid cancer is not clearly reported in the literature, although its impact in other cancers is well-defined. The aim of the following illustrative clinical cases is to highlight the impact of PET/CT in the management of different phases of parathyroid cancer. We describe five patients with parathyroid malignant lesions, who underwent FDG PET/CT at initial staging, restaging and post-surgery evaluation. In each patient we report the value of PET/CT comparing its findings with other common imaging modalities (e.g., CT, planar scintigraphy with 99mTc-sestamibi, magnetic resonance imaging) thus determining the complementary benefit of FDG PET/CT in parathyroid carcinoma. We hope to provide an insight into the potential role of PET/CT in assessing the extent of disease and response to treatment which are the general principles used to correctly evaluate disease status.

Keywords: 18F-Fluorodeoxyglucose; Parathyroid carcinoma; Positron emission tomography/computed tomography; Restaging; Staging.

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Figures

Figure 1
Figure 1
Staging. Right: At Maximum intensity projection the parathyroid and pleural involvements are visible; Central and left: High 18F-Fluorodeoxyglucose-uptake is clearly displayed corresponding to the left parathyroid gland and right pleura in coronal, transverse and sagittal planes.
Figure 2
Figure 2
Restaging. A: Pre-surgical 99mTc99 sestamibi early (15 min) and delayed (2 h) images showed the presence of high uptake in the right inferior parathyroid gland; B: Post-surgical scintigraphy scan demonstrated high tracer uptake in the left inferior parathyroid gland at early and late images, whereas no 18F-Fluorodeoxyglucose-uptake in the same gland during the positron emission tomography/computed tomography scan was reported.
Figure 3
Figure 3
Progression of disease. Right: First positron emission tomography/computed tomography (PET/CT) exam demonstrated moderate and diffuse skeletal involvement, particularly in medullar bone; Left: Second PET/CT scan, performed 5 mo after earlier PET exam, showed progression of skeletal disease.
Figure 4
Figure 4
Post-surgical evaluation. Up: First positron emission tomography/computed tomography (PET/CT) scan performed at least 50 d after curative surgery, demonstrated mild 18F-Fluorodeoxyglucose (FDG) uptake corresponding to the right lateral wall of the larynx; Down: Second PET/CT exam, performed 4 mo after curative surgery, demonstrated the disappearance of FDG-uptake at the same site.
See this image and copyright information in PMC

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