Dual-Tracer Positron Emission Tomography/Computed Tomography with [18F]FDG and [18F]fluorocholine in a Patient with Metastatic Parathyroid Carcinoma

Cesare Michele Iacovitti; Marco Cuzzocrea; Lauro Gianola; Gaetano Paone; Giorgio Treglia

doi:10.3390/diagnostics14141548

Dual-Tracer Positron Emission Tomography/Computed Tomography with [¹⁸F]FDG and [¹⁸F]fluorocholine in a Patient with Metastatic Parathyroid Carcinoma

Diagnostics (Basel). 2024 Jul 17;14(14):1548. doi: 10.3390/diagnostics14141548.

Authors

Cesare Michele Iacovitti¹, Marco Cuzzocrea¹, Lauro Gianola², Gaetano Paone^{1

3}, Giorgio Treglia^{1

3

4}

Affiliations

¹ Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland.
² Service of Endocrinology, Department of Medicine, Ente Ospedaliero Cantonale, 6850 Mendrisio, Switzerland.
³ Faculty of Biomedical Sciences, Università della Svizzera italiana, 6900 Lugano, Switzerland.
⁴ Faculty of Biology and Medicine, University of Lausanne, 1015 Lausanne, Switzerland.

Abstract

Here, we describe the case of a 43-year-old male patient with a metastatic parathyroid carcinoma who underwent dual-tracer whole-body positron emission tomography/computed tomography (PET/CT) with [¹⁸F]fluorocholine and fluorodeoxyglucose ([¹⁸F]FDG) for staging. [¹⁸F]FDG PET/CT detected multiple cervical and mediastinal lymph nodal lesions with increased tracer uptake, whereas [¹⁸F]fluorocholine PET/CT detected increased tracer uptake on cervical and mediastinal lymph nodal lesions and bone and lung lesions with a better evaluation of metastatic spread. Due to these imaging findings, the patient underwent systemic treatment with chemotherapy. This case demonstrates the added value of dual-tracer PET/CT in this rare metastatic tumor.

Keywords: FDG; choline; dual-tracer; hybrid imaging; nuclear medicine; parathyroid carcinoma; positron emission tomography (PET).