Lokalisationsdiagnostik von Nebenschilddrüsenadenomen mittels PET/CT

Zusammenfassung

Die häufigste Ursache eines primären Hyperparathyreoidismus ist ein funktionell relevantes Nebenschilddrüsenadenom, welches meist solitär, teils jedoch auch ektop vorkommen kann. In Vorbereitung der kausalen Therapie, dem operativen Vorgehen, ist eine exakte Lokalisationsdiagnostik essenziell um den Eingriff genau zu planen und so wenig traumatisch wie möglich zu gestalten. Dadurch kann die Häufigkeit von Komplikationen wie postoperativem Hypoparathyreoidismus, aber z. B. auch einer Recurrensparese deutlich vermindert werden. In der Regeldiagnostik kommen zervikaler Ultraschall, MRT und ^99 mTc-MIBI-Szintigrafie zur Anwendung. Bei fehlendem oder uneindeutigem Befund kann eine ergänzende PET-Diagnostik (¹⁸F-Cholin; ¹¹C-Cholin; ¹¹C-Methionin) erfolgen, wodurch häufig doch noch eine Lokalisierung gelingt. Im Vergleich zum Einsatz von Subtraktionsszintigrafie und SPECT/CT wird für den Einsatz der PET/CT zudem eine niedrigere Strahlenexposition für die Patienten beschrieben.

Abstract

Parathyroid adenomas are the most common cause of primary hyperparathyroidism. Proper pretreatment localisation is essential to plan the surgical approach with a minimum of risk (e. g. hypoparathyroidism or recurrent nerve paralysis). Cervical ultrasound, MRI and ^99mTc-MIBI-scintigraphy are used routinely. In case of a lack of diagnostic findings the use PET-CT (¹⁸F-choline; ¹¹C-choline; ¹¹C-methionine) is reasonably. Detection of parathyroid adenoma is able in many cases causing less radiation exposure than conventional imaging.

Schlüsselwörter

Primärer Hyperparathyreoidismus - Nebenschilddrüsenadenom - ^99 mTc-MIBI-Szintigrafie - ¹⁸F-Cholin - ¹¹C-Cholin - ¹¹C-Methionin PET/CT

Keywords

Primary hyperparathyroidism - parathyroid adenoma - 99m-Tc-MIBI-scintigraphy - F-18-choline - C-11-choline - C11-methionine PET-CT

Publikationsverlauf

Artikel online veröffentlicht:
21. September 2020

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