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Background. Positron emission tomography (PET) has not been evaluated for preoperalive localization and functional characterization of the parathyroid tissue in hyperparathyroidism.
Methods. Images of the neck and upper mediastinum of 23 patients with hyperparathyrnidisin 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 patathyroid glands in hyperparathyroidism.
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- Monoclonal antiparathyroid antibodies interfering with a Ca2+-sensor of human parathyroid cells.Biochem Biophys Res Commun. 1987; 143: 570-574
- Hyperparathyrbidism is associated with reduced expression of a parathyroid calcium receptor mechanism defined by monoclonal antiparathyroid antibodies.Endocrinology. 1987; 122: 2999-3001
- Regulation of cytoplasmic Ca2+ and hormone- release of the parathyroid cell.in: Dumont J.E. Nunez J. King R.J.B. Hormones and cell regulation. John Libbey Eurotext Ltd, London1990: 5-15
- Relationship between external and cytoplasmic calcium concentrations, parathyroid hormone release and weight of parathyroid glands in human hyperparathyroidism.J Endocrinol. 1988; 116: 457-464
- Histologicparathyroid abnormalities in an autopsy series.Hum Pathol. 1986; 17: 520-527
- Cell kinetics in parathyroid adenomas: evidence for decline in rates of cell birth and tumour growth, assuming clonal origin.Clin Endocrinol (OxE). 1991; 35: 151-157
- Functional epithelial cell line cloned from rat parathyroid glands.in: 2nd ed. Proc Natl Acad Sci U S A. 84. 1987: 3269-3273
- 1,25(OH)2D3 inhibits hormone secretion and proliferation but not functional dedifferentiation of cultured bovine parathyroid cells.Calcif Tissue Int. 1988; 43: 213-218
- Modulation of the Ca2+-sensing function of parathyroid cells in vitro and in I hyperparathyroidism.Biochim Biophys Acta. 1988; 968: 253-260
- Influence of calcium and-1,25-dihydroxycholecalciferolon proliferation and proto-oncogene expression in primary cultures of bovine parathyroid cells.Endocrinology. 1989; 125: 935-941
- Clinical characteristics and surgical treatment of sporadic primary hyperparathyroidism with emphasis on chief cell hyperplasia.Surgery. 1990; 107: 13-19
- Preoperative localization and interventional treatment of parathyroid tumors.World J Surg. 1991; 15: 706-715
- Causes of failed primary exploration and technical aspects of reoperation in primary hyperparathyroidism.World J Surg. 1992; 16: 562-568
- Parathyroid gland.in: Higgins C.B. Auffermann W. Endocrine imaging. Georg Thieme Verlag, Stuttgart1994: 85-128
- Simultaneous dual energy acquisition for 201Tl/99Tcm parathyroid subtraction scintigraphy: physical and physiological consideration.Nucl Med Commun. 1990; 11: 503-510
- Positron emission tomography in the study of pituitary adenomas.J Endocrinol Invest. 1991; 14: 509-528
- The parathyroid glands.in: Kovacs K. Asa L. Functional endocrine pathology. Blackwell Scientific Publishers, Boston1991: 375-395
- Synthesis of L- and d-[methyl-11C]-methionine.J Nucl Med. 1987; 28: 1037-1040
- Stimulation of parathyroid hormone secretion by EDTA infusion: a test for the differential diagnosis of hypercalcemia.Acta Endocrinol. 1986; 111: 498-506
- Disturbance of basal and stimulated serum levels of intact parathyroid hormone in primary hyperparathyroidism.Surgery. 1991; 110: 47-53
- Extracellular Ca2+ sensing, regulation of parathyroid cell function, and role of Ca2+ and other ions as extracellular (first) messengers.Physiol Rev. 1991; 71: 371-411
- Stimulus-secretion coupling of parathyroid hormone release: studies of 45Ca and 86Rb fluxes.Acta Physiol Scand. 1985; 124: 239-245
- Parathyroid hormone: biochemical aspects of biosynthesis, secretion, action and metabolism.Physiol Rev. 1984; 64: 985-1053
- The by-pass of tissue hormone stores during the secretion of newly synthesized parathyroid hormone.Endocrinology. 1975; 97: 178-188
- Long-term effects of parathyroid operation on serum calcium and parathyroid hormone values in sporadic primary hyperparathyroidism.Surgery. 1992; 112: 1123-1129
- Highly sensitive two-site immunoradiometric assay of parathyrin and its clinical utility in evaluating patients with hypercalcemia.Clin Chem. 1987; 33: 1364-1367
☆Supported by the Swedish Cancer Society.
☆☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.
© 1994 Published by Elsevier Inc.