PRIMARY HYPERPARATHYROIDISM - PREOPERATIVE PARATHYROID IMAGING WITH REGIONAL BODY FDG PET

PURPOSE: To explore the feasibility of use of positron emission tomogr aphy (PET) with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) to loca lize abnormal parathyroid tissue. MATERIALS AND METHODS: Regional body FDG PET with attenuation correction was performed in 17 adult patient s with primary hyperparathyroidism (HPT) prior to surgical neck explor ation. The regional body FDG PET results were correlated with surgical and histopathologic findings. RESULTS: Surgical neck exploration reve aled 18 parathyroid adenomas in 16 patients and four hyperplastic para thyroid glands in one patient. Regional body FDG PET allowed correct l ocalization of 17 of the 18 parathyroid adenomas (94% sensitivity) and two of the four hyperplastic parathyroid glands (50% sensitivity). Th ree false-positive FDG PET findings were encountered, including two fo llicular thyroid adenomas. CONCLUSION: Regional body FDG PET is a prom ising procedure for preoperative localization of pathologic parathyroi d tissue in patients with primary HPT.