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Fig. 2 | EJNMMI Research

Fig. 2

From: A retrospective analysis of the diagnostic performance of 11C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism

Fig. 2

Patient example of a negative 99mTc-MIBI-SPECT/CT and a positive 11C-choline PET/CT. Previously, the patient underwent a hemithyroidectomy on the left side because of a thyroid nodule, which proved to be benign. Planar anterior image of the neck with 99mTc-pertechnetate (a) and early 99mTc-MIBI (b) showing physiological uptake in the right thyroid lobe. Planar subtraction image (early 99mTc-MIBI minus 99mTc-pertechnetate image c) also does not show the parathyroid adenoma. The uptake in the right thyroid lobe was also observed on the 99mTc-MIBI-SPECT image d. The low dose-CT of the 99mTc-MIBI-SPECT/CT e retrospectively did show a focus suspect for a parathyroid adenoma located paraoesophageally on the right side (red arrow). The 11C-choline PET/CT (f fused PET/CT image and g, h PET only image) showed this same lesion (1.80 cm and 1.00 g at pathology) located paraoesophageally on the right side, suspicious for a parathyroid adenoma (red arrow). The 11C-choline PET/CT also showed the same physiological uptake in the right thyroid lobe (fh)

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