{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:08:43Z","timestamp":1793351323775,"version":"4.5.0"},"reference-count":31,"publisher":"IOP Publishing","issue":"1","license":[{"start":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T00:00:00Z","timestamp":1518652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/publishingsupport.iopscience.iop.org\/iop-standard\/v1"},{"start":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T00:00:00Z","timestamp":1518652800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["J. Radiol. Prot."],"published-print":{"date-parts":[[2018,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background.<\/jats:italic>\n                    Parathyroid subtraction scintigraphy (PSS) is the most commonly used imaging method for localisation of hyperfunctioning parathyroid glands (HPGs) in primary hyperparathyroidism (PHP), a common endocrine disorder. Hybrid (SPECT\/CT) imaging with\n                    <jats:sup>99m<\/jats:sup>\n                    Tc-sestaMIBI (MIBI) at an early and delayed phase (dual-phase imaging) may be the most accurate conventional imaging approach, but includes additional radiation exposure due to added CT imaging. Recently,\n                    <jats:sup>18<\/jats:sup>\n                    F-choline (FCH) PET\/CT was introduced for HPG imaging, which can also be performed using the dual-phase approach. To date, no studies have compared organ doses and the effective dose (ED) from conventional subtraction scintigraphy, dual-phase MIBI SPECT\/CT, and FCH PET\/CT in the localisation of HPGs.\n                    <jats:italic>Aim.<\/jats:italic>\n                    In addition to the comparison of the diagnostic performance of FCH PET\/CT and conventional scintigraphic imaging methods, the aim of the study was to measure the organ doses and the ED for conventional subtraction parathyroid imaging protocols, using dual-phase MIBI SPECT\/CT as a potential conventional imaging method of choice and FCH dual-phase PET\/CT as a potential future imaging method of choice for the localisation of HPGs.\n                    <jats:italic>Materials, methods.<\/jats:italic>\n                    Thirty-six patients referred for parathyroid imaging with a clinical indication of PHP underwent preoperative PSS and dual-phase SPECT\/CT imaging with the addition of FCH PET\/CT. The diagnostic performance of the imaging modalities was assessed by using histology results as a gold standard. Radiation exposure was calculated for the administered activities of radiopharmaceuticals using ICRP80 weighting factors and for CT exposure at hybrid imaging using dose-length products and the ImPACT CT Patient Dosimetry Calculator.\n                    <jats:italic>Results<\/jats:italic>\n                    . The diagnostic performance of FCH PET\/CT was significantly better than that of conventional imaging modalities (sensitivity of 97% vs 64% and 46% for MIBI SPECT\/CT and PSS, respectively, with comparable specificity of over 95% for all modalities). The highest radiation exposure was caused by conventional PSS (7.4 mSv), followed by dual-phase MIBI SPECT\/CT (6.8 mSv). The radiation exposure was the lowest for dual-phase FCH PET\/CT imaging (2.8 mSv). The added CT imaging for both hybrid approaches did not cause significant additional radiation exposure (1.4 mSv for MIBI SPECT\/CT, additional 26.4% to overall exposure; 0.8 mSv for FCH PET\/CT, additional 42.4% to overall exposure).\n                    <jats:italic>Conclusion.<\/jats:italic>\n                    In comparison to conventional scintigraphic imaging of HPGs, emerging hybrid (SPECT\/CT, PET\/CT) imaging techniques combine superior diagnostic performance with lower radiation exposure to patients.\n                  <\/jats:p>","DOI":"10.1088\/1361-6498\/aaa86f","type":"journal-article","created":{"date-parts":[[2018,1,17]],"date-time":"2018-01-17T10:15:52Z","timestamp":1516184152000},"page":"343-356","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":60,"title":["<sup>18<\/sup>\n                    F-choline PET\/CT for parathyroid scintigraphy: significantly lower radiation exposure of patients in comparison to conventional nuclear medicine imaging approaches"],"prefix":"10.1088","volume":"38","author":[{"given":"Sebastijan","family":"Rep","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Hocevar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janja","family":"Vaupotic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urban","family":"Zdesar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Zaletel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1341-403X","authenticated-orcid":false,"given":"Luka","family":"Lezaic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2018,2,15]]},"reference":[{"key":"jrpaaa86fbib1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e1013","type":"journal-article","article-title":"Diagnosis and management of primary hyperparathyroidism","volume":"344","author":"Pallan","year":"2012","journal-title":"BMJ"},{"key":"jrpaaa86fbib2","doi-asserted-by":"publisher","first-page":"410","DOI":"10.3978\/j.issn.2227-684X.2015.03.07","type":"journal-article","article-title":"Minimally invasive parathyroid surgery","volume":"4","author":"Noureldine","year":"2015","journal-title":"Gland Surg."},{"key":"jrpaaa86fbib3","doi-asserted-by":"publisher","first-page":"1924","DOI":"10.1245\/s10434-016-5694-1","type":"journal-article","article-title":"Focused versus bilateral parathyroid exploration for primary hyperparathyroidism: a systematic review and meta-analysis","volume":"24","author":"Jinih","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"jrpaaa86fbib4","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s00259-009-1131-z","type":"journal-article","article-title":"2009 EANM parathyroid guidelines","volume":"36","author":"Hindi\u00e9","year":"2009","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"jrpaaa86fbib5","doi-asserted-by":"publisher","first-page":"111","DOI":"10.2967\/jnmt.112.105122","type":"journal-article","article-title":"SNM practice guideline for parathyroid scintigraphy 4.0","volume":"40","author":"Greenspan","year":"2012","journal-title":"J. Nucl. Med. Technol."},{"key":"jrpaaa86fbib6","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1097\/00003072-199704000-00001","type":"journal-article","article-title":"Preliminary experience with double-phase SPECT using Tc-99m sestamibi in patients with hyperparathyroidism","volume":"22","author":"Neumann","year":"1997","journal-title":"Clinical Nuclear Medicine"},{"key":"jrpaaa86fbib7","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.2967\/jnumed.107.040428","type":"journal-article","article-title":"Comparison of SPECT\/CT, SPECT, and planar imaging with single- and dual-phase (99m)Tc-sestamibi parathyroid scintigraphy","volume":"48","author":"Lavely","year":"2007","journal-title":"J. Nucl. Med."},{"key":"jrpaaa86fbib8","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1007\/s00259-014-2837-0","type":"journal-article","article-title":"18F-Fluorocholine PET\/CT for localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism: a pilot study","volume":"41","author":"Lezaic","year":"2014","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"jrpaaa86fbib9","doi-asserted-by":"publisher","first-page":"e328","DOI":"10.1097\/RLU.0b013e3182a77b62","type":"journal-article","article-title":"False-positive result in 18F-fluorocholine PET\/CT due to incidental and ectopic parathyroid hyperplasia","volume":"39","author":"Cazaentre","year":"2014","journal-title":"Clin. Nucl. Med."},{"key":"jrpaaa86fbib10","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001701","type":"journal-article","article-title":"A pilot comparison of 18F-fluorocholine PET\/CT, Ultrasonography and 123I\/99mTc-sestaMIBI dual-phase dual-isotope scintigraphy in the preoperative localization of hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism: influence of thyroid anomalies","volume":"94","author":"Michaud","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"jrpaaa86fbib11","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1016\/j.ejrad.2015.05.024","type":"journal-article","article-title":"Enabling minimal invasive parathyroidectomy for patients with primary hyperparathyroidism using Tc-99m-sestamibi SPECT-CT, ultrasound and first results of (18)F-fluorocholine PET-CT","volume":"84","author":"Kluijfhout","year":"2015","journal-title":"Eur. J. Radiol."},{"key":"jrpaaa86fbib12","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/897202","type":"journal-article","article-title":"Quantifying the increase in radiation exposure associated with SPECT\/CT compared to SPECT alone for routine nuclear medicine examinations","volume":"2011","author":"Larkin","year":"2011","journal-title":"Int. J. Mol. Imaging"},{"key":"jrpaaa86fbib13","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1097\/MNM.0b013e328355b6d5","type":"journal-article","article-title":"SPECT-CT in routine clinical practice: increase in patient radiation dose compared with SPECT alone","volume":"33","author":"Sharma","year":"2012","journal-title":"Nucl. Med. Commun."},{"key":"jrpaaa86fbib14","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1007\/s12149-013-0724-6","type":"journal-article","article-title":"Estimation of the total effective dose from low-dose CT scans and radiopharmaceutical administrations delivered to patients undergoing SPECT\/CT explorations","volume":"27","author":"Montes","year":"2013","journal-title":"Ann. Nucl. Med."},{"key":"jrpaaa86fbib15","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s40336-014-0093-8","type":"journal-article","article-title":"SPECT\/CT radiation dosimetry","volume":"2","author":"Ferrari","year":"2014","journal-title":"Clin. Transl. Imaging"},{"key":"jrpaaa86fbib16","first-page":"1","type":"journal-article","article-title":"Radiation dose to patients from radiopharmaceuticals (addendum 2 to ICRP publication 53)","volume":"28","author":"International Commission on Radiological Protection","year":"1998","journal-title":"Ann. ICRP"},{"key":"jrpaaa86fbib17","first-page":"1","type":"journal-article","article-title":"The 2007 Recommendations of the International Commission on Radiological Protection (ICRP publication 103)","volume":"2007","author":"International Commission on Radiological Protection","year":"2007","journal-title":"Ann. ICRP"},{"key":"jrpaaa86fbib18","first-page":"1","type":"journal-article","article-title":"Radiation dose to patients from radiopharmaceuticals (A fourth addendum to ICRP Publication 53)","volume":"43","year":"2013","journal-title":"Ann. ICRP"},{"key":"jrpaaa86fbib19","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1053\/j.semnuclmed.2005.06.001","type":"journal-article","article-title":"Radionuclide imaging of the parathyroid glands","volume":"35","author":"Palestro","year":"2005","journal-title":"Semin. Nucl. Med."},{"key":"jrpaaa86fbib20","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1097\/RLU.0b013e318251e408","type":"journal-article","article-title":"Parathyroid scintigraphy: when, how, and why\u00a0?\u00a0A concise systematic review","volume":"37","author":"Taieb","year":"2012","journal-title":"Clin. Nucl. Med."},{"key":"jrpaaa86fbib21","doi-asserted-by":"publisher","first-page":"737","DOI":"10.2967\/jnumed.115.156018","type":"journal-article","article-title":"The role of radionuclide imaging in the surgical management of primary hyperparathyroidism","volume":"56","author":"Hindi\u00e9","year":"2015","journal-title":"J. Nucl. Med."},{"key":"jrpaaa86fbib22","first-page":"127","type":"journal-article","article-title":"Comparison of SPET\/CT, SPET and planar imaging using 99mTc-MIBI as independent techniques to support minimally invasive parathyroidectomy in primary hyperparathyroidism: a meta-analysis","volume":"18","author":"Wei","year":"2015","journal-title":"Hell. J. Nucl. Med."},{"key":"jrpaaa86fbib23","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1097\/MNM.0000000000000262","type":"journal-article","article-title":"Parathyroid adenoma localization with 99mTc-sestamibi SPECT\/CT: a meta-analysis","volume":"36","author":"Wong","year":"2015","journal-title":"Nucl. Med. Commun."},{"key":"jrpaaa86fbib24","doi-asserted-by":"publisher","first-page":"E2159","DOI":"10.1002\/hed.24027","type":"journal-article","article-title":"Detection rate of (99m) Tc-MIBI single photon emission computed tomography (SPECT)\/CT in preoperative planning for patients with primary hyperparathyroidism: A meta-analysis","volume":"38","author":"Treglia","year":"2016","journal-title":"Head Neck"},{"key":"jrpaaa86fbib25","doi-asserted-by":"publisher","first-page":"180","DOI":"10.2214\/AJR.13.11053","type":"journal-article","article-title":"Value of dual-phase (99m)Tc-sestamibi scintigraphy with neck and thoracic SPECT\/CT in secondary hyperparathyroidism","volume":"202","author":"Yang","year":"2014","journal-title":"AJR Am. J. Roentgenol."},{"key":"jrpaaa86fbib26","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1007\/s00268-011-1365-3","type":"journal-article","article-title":"Parathyroid four-dimensional computed tomography: evaluation of radiation dose exposure during preoperative localization of parathyroid tumors in primary hyperparathyroidism","volume":"36","author":"Mahajan","year":"2012","journal-title":"World J. Surg."},{"key":"jrpaaa86fbib27","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1001\/jamasurg.2013.57","type":"journal-article","article-title":"Comparison of radiation exposure and cost between dynamic computed tomography and sestamibi scintigraphy for preoperative localization of parathyroid lesions","volume":"148","author":"Madorin","year":"2013","journal-title":"JAMA Surg."},{"key":"jrpaaa86fbib28","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1210\/jc.2012-3168","type":"journal-article","article-title":"Clinical review: Parathyroid localization and implications for clinical management","volume":"98","author":"Kunstman","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"jrpaaa86fbib29","doi-asserted-by":"publisher","first-page":"W579","DOI":"10.2214\/AJR.14.13278","type":"journal-article","article-title":"Lifetime attributable risk of cancer from radiation exposure during parathyroid imaging: comparison of 4D CT and parathyroid scintigraphy","volume":"204","author":"Hoang","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"jrpaaa86fbib30","doi-asserted-by":"publisher","first-page":"1959","DOI":"10.1007\/s00259-010-1390-8","type":"journal-article","article-title":"A review on the clinical uses of SPECT\/CT","volume":"37","author":"Mariani","year":"2010","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"jrpaaa86fbib31","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1515\/raon-2015-0016","type":"journal-article","article-title":"Optimal scan time for evaluation of parathyroid adenoma with [(18)F]-fluorocholine PET\/CT","volume":"49","author":"Rep","year":"2015","journal-title":"Radiol Oncol."}],"container-title":["Journal of Radiological Protection"],"original-title":[],"link":[{"URL":"http:\/\/stacks.iop.org\/0952-4746\/38\/i=1\/a=343?key=crossref.73d7ff4efc1a11dfe8312ff6751d781c","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"text-mining"},{"URL":"http:\/\/stacks.iop.org\/0952-4746\/38\/i=1\/a=343\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f","content-type":"text\/html","content-version":"am","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f\/pdf","content-type":"application\/pdf","content-version":"am","intended-application":"similarity-checking"},{"URL":"http:\/\/stacks.iop.org\/0952-4746\/38\/i=1\/a=343\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/stacks.iop.org\/0952-4746\/38\/i=1\/a=343?key=crossref.73d7ff4efc1a11dfe8312ff6751d781c","content-type":"text\/html","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T14:19:23Z","timestamp":1775917163000},"score":1,"resource":{"primary":{"URL":"https:\/\/iopscience.iop.org\/article\/10.1088\/1361-6498\/aaa86f"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,15]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,2,15]]},"published-print":{"date-parts":[[2018,3,1]]}},"URL":"https:\/\/doi.org\/10.1088\/1361-6498\/aaa86f","relation":{},"ISSN":["0952-4746","1361-6498"],"issn-type":[{"value":"0952-4746","type":"print"},{"value":"1361-6498","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,15]]},"assertion":[{"value":"18\n                      F-choline PET\/CT for parathyroid scintigraphy: significantly lower radiation exposure of patients in comparison to conventional nuclear medicine imaging approaches","name":"article_title","label":"Article Title"},{"value":"Journal of Radiological Protection","name":"journal_title","label":"Journal Title"},{"value":"paper","name":"article_type","label":"Article Type"},{"value":"\u00a9 2018 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.","name":"copyright_information","label":"Copyright Information"},{"value":"2017-08-17","name":"date_received","label":"Date Received","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2018-01-17","name":"date_accepted","label":"Date Accepted","group":{"name":"publication_dates","label":"Publication dates"}},{"value":"2018-02-15","name":"date_epub","label":"Online publication date","group":{"name":"publication_dates","label":"Publication dates"}}]}}