Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 23;15(1):10018.
doi: 10.1038/s41598-025-94735-2.

Contribution of 18 F-fluorocholine PET-CT to the preoperative localisation of parathyroid adenoma for the treatment of primary hyperparathyroidism

Suzanne Garnier  1 , Clémentine Mahéo  2 , Gael Potard  2 , Marie-Béatrice Cavarec  3 , Nathalie Roudaut  4 , Philippe Thuillier  4 , Rémi Marianowski  2 , Ronan Abgral  3 , Jean-Christophe Leclere  2
Affiliations

Contribution of 18 F-fluorocholine PET-CT to the preoperative localisation of parathyroid adenoma for the treatment of primary hyperparathyroidism

Suzanne Garnier et al. Sci Rep. .

Abstract

18 F-fluorocholine PET-CT is considered a second-line method for the preoperative localisation of parathyroid adenomas in primary hyperparathyroidism. The aim was to compare the diagnostic performance of 18 F-fluorocholine PET-CT and standard imaging modalities in the preoperative localisation of parathyroid adenomas in primary hyperparathyroidism. The primary objective was to assess the performance of 18 F-fluorocholine PET-CT in cases of negative or discordant standard imaging. The secondary objective was to evaluate the diagnostic performance of both 18 F-fluorocholine PET-CT and standard imaging in relation to patient characteristics. We conducted a retrospective, monocentric study, including 156 patients who underwent parathyroidectomy between 2017 and 2023. All patients underwent preoperative 18 F-fluorocholine PET-CT and had an indication for surgery due to primary hyperparathyroidism. A total of 156 patients were included in the study, the majority of whom were women (78%). Seven patients had multigland disease (4.49%). Sensitivity was 60.14% for cervical ultrasound, 46.21% for [99mTc]-MIBI scintigraphy, and 95.97% for 18 F-Fluorocholine PET-CT. 18 F-Fluorocholine PET-CT showed a higher sensitivity than cervical ultrasound and [99mTc]-MIBI scintigraphy, especially for multiple parathyroid adenomas (100, 57.14, and 42.86%, respectively). Univariate analysis showed better results for cervical ultrasound in men (p = 0.005). Larger adenomas showed better performance on [99mTc]-MIBI scintigraphy (p = 0.026), and elevated PTH levels were associated with significantly worse performance on 18 F-fluorocholine PET-CT (p = 0.023). Multivariate analysis showed that scintigraphy performance was worse in the presence of thyroid nodules (p = 0.049, RR = 2.046, 95% CI 1.005-4.166). 18 F-fluorocholine PET-CT is a valuable imaging modality for the preoperative localisation of parathyroid adenomas in primary hyperparathyroidism, with superior performance compared to conventional imaging modalities. [99mTc]-MIBI scintigraphy showed reduced diagnostic performance in the presence of thyroid nodules.

Keywords: 18F-Fluorocholine PET-CT; Parathyroid adenoma; Parathyroid scintigraphy.; Primary hyperparathyroidism.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow-chart.
See this image and copyright information in PMC

References

    1. Bilezikian, J. P. and al., International workshop on primary hyperparathyroidism, evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the fifth international workshop. J. Bone Miner. Res.37 (11), 2293–2314. (2022). - PubMed
    1. Cuderman, A. 18F-Fluorocholine PET/CT in primary hyperparathyroidism: superior diagnostic performance to conventional scintigraphic imaging for localization of hyperfunctioning parathyroid glands. J. Nucl. Med.61 (4), 577–583 (2020). - DOI - PubMed
    1. Madkhali, T., Alhefdhi, A., Chen, H. & Elfenbein, D. Primary hyperparathyroidism. Ulus Cerrahi Derg.32 (1), 58–66 (2016). - PMC - PubMed
    1. Giovanella, L. Will 18F-fluorocholine PET/CT replace other methods of preoperative parathyroid imaging ? Endocrine71, 285–297 (2021). - DOI - PubMed
    1. Ferrari, S. B. Clinical predictors of negative/equivocal SPECT imaging outcomes in primary hyperparathyroidism: factors calling for 18F-choline-PET. Am. J. Otolaryngol.45 (4), 104315 (2024). - DOI - PubMed

MeSH terms

LinkOut - more resources