Clinical Nuclear Medicine

Skip Navigation LinksHome > March 2014 - Volume 39 - Issue 3 > 18F-FDG PET Rarely Provides Additional Information to 11C-Me...
Clinical Nuclear Medicine:
doi: 10.1097/RLU.0000000000000340
Original Articles

18F-FDG PET Rarely Provides Additional Information to 11C-Methionine PET Imaging in Hyperparathyroidism

Chicklore, Sugama MRCS, MSc*; Schulte, Klaus-Martin FRCS; Talat, Nadia BSc; Hubbard, Johnathan G. FRCS; O’Doherty, Michael MD*; Cook, Gary J.R. MD*

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Aim: The aim of this study was to assess the utility of combined 11C-methionine and 18F-FDG PET/CT imaging in hyperparathyroidism.

Patients and Methods: We reviewed all scans performed for hyperparathyroidism with both 11C-methionine and 18F-FDG PET/CT or PET in our institution since 1993. Forty-three patients (47 pairs of scans) were included (13 men and 30 women) with a mean age of 63 years. 11C-methionine and 18F-FDG PET/CT scans were classified as positive or negative for localization of abnormal parathyroid tissue, and the site of uptake was noted in the positive scans. Other concurrent imaging (99mTc-MIBI scintigraphy, ultrasonography, CT, or MRI) findings were also noted when performed. Clinical follow-up information was available in 27 patients (30 episodes).

Results: Of the 47 PET scan episodes, 23 (49%) were positive. Twenty-two 11C-methionine scans showed abnormal focal localization of which 10 also showed concordant abnormal 18F-FDG uptake. One patient was positive with 18F-FDG and negative with 11C-methionine.

Of the 16 patients who underwent subsequent surgery, 6 had concordant 11C-methionine, 18F-FDG, and surgical findings; 6 had concordant 11C-methionine and surgical findings; 1 had concordant 18F-FDG and surgical findings; and 3 had both PET scans negative but had adenomas excised during surgery.

Of the 3 with both PET scans negative and discordant surgical findings, 1 had mediastinal parathyroid lipoadenoma excised and 2 had normally sited parathyroid adenoma excised.

Conclusions: 18F-FDG PET/CT rarely provides additional information and could be saved for patients in whom 11C-methionine PET/CT is negative.

© 2014 by Lippincott Williams & Wilkins


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