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Positron emission t...
Positron emission tomography with 11C-methionine in hyperparathyroidism
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- Hellman, Per (author)
- Uppsala universitet,Endokrinkirurgi
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- Ahlström, Håkan (author)
- Uppsala universitet,Enheten för radiologi
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Bergström, M (author)
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- Sundín, Anders (author)
- Uppsala universitet,Enheten för radiologi
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- Långström, Bengt (author)
- Uppsala universitet,Institutionen för biokemi och organisk kemi
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Westerberg, G (author)
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Juhlin, C (author)
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- Åkerström, Göran (author)
- Uppsala universitet,Endokrinkirurgi
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Rastad, J (author)
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(creator_code:org_t)
- 1994
- 1994
- English.
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In: Surgery. - 0039-6060 .- 1532-7361. ; 116:6, s. 974-981
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https://urn.kb.se/re...
Abstract
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- BACKGROUND: Positron emission tomography (PET) has not been evaluated for preoperative localization and functional characterization of the parathyroid tissue in hyperparathyroidism. METHODS: Images of the neck and upper mediastinum of 23 patients with hyperparathyroidism were obtained by PET after intravenous administration of 400 to 800 MBq L-[methyl-11C]-methionine. The investigation was repeated in six patients after Na2-ethylenediamine tetraacetic acid infusion, whereby stable 65% to 157% rise in intact serum parathyroid hormone values was attained. RESULTS: Parathyroid surgical procedure revealed single (21 patients) or two enlarged parathyroid glands (two patients) that were characterized as chief cell adenoma (n = 13), hyperplasia (n = 10), or carcinoma (n = 2) and weighed 80 to 6000 mg. Twenty (80%) of these glands were localized by PET. The remaining examinations (20%) were false negative and mainly encompassed small parathyroids in juxtathyroid position. Among 15 patients undergoing parathyroid reoperation true-positive localizations were obtained for 87% of the glands. The images displayed lower tracer uptake in residual thyroid lobes (n = 40), esophagus, and cervical vertebrae. Na2-ethylenediamine tetraacetic acid infusion failed to enhance parathyroid uptake values. Ultrasonography, computed tomography, technetium-thallium scintigraphy, and venous sampling revealed 25% to 53% of the pathologic parathyroid tissues of the patients undergoing reoperation and was largely complementary to PET. CONCLUSIONS: The results suggest that PET may provide novel possibilities for the imaging of pathologic parathyroid glands in hyperparathyroidism.
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