{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T03:57:30Z","timestamp":1774497450672,"version":"3.50.1"},"reference-count":10,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Tertiary hyperparathyroidism (HPT) is a metabolic disorder characterized by the semi-autonomous hypersecretion of parathyroid hormone (PTH), leading to hypercalcemia. It can be the end result of persistent secondary hyperparathyroidism and is most commonly observed in patients with long-standing chronic kidney disease (CKD) and often after renal transplantation. Untreated HPT can lead to progressive bone disease, fibrocystic osteitis, and soft-tissue calcifications, along with other severe complications. In the 2009 Kidney Disease Improving Global Outcomes (KDIGO) guidelines, CKD-Mineral and Bone Disorder (CKD-MBD) is used to describe the broader clinical syndrome encompassing mineral, bone, and calcific cardiovascular abnormalities that develop as a complication of CKD. We report a 62-year-old female with a severe HPT evolved from advanced chronic kidney disease (stage 5D, KDIGO). Patient was evaluated with multimodality nuclear medicine functional imaging to assess hyperfunctioning parathyroid glands and bone lesions. Tc-99m-methoxyisobutylisonitrile (MIBI) dual-phase scintigraphy, Tc-99m-methylenediphosphonate (MDP) bone scan and 18F-Fluorocholine positron emission tomography\/computed tomography (18F-FCH PET\/CT) were performed before surgery.<\/jats:p>","DOI":"10.3390\/diagnostics10100851","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T09:28:23Z","timestamp":1603186103000},"page":"851","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["18F-Fluorocholine PET\/CT, Tc-99m-MIBI and TC-99m-MDP SPECT\/CT in Tertiary Hyperparathyroidism with Renal Osteodystrophy"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0168-8551","authenticated-orcid":false,"given":"Cristina","family":"Ferrari","sequence":"first","affiliation":[{"name":"Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Lavelli","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-0686","authenticated-orcid":false,"given":"Giulia","family":"Santo","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Frugis","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5567-6171","authenticated-orcid":false,"given":"Francesca","family":"Iuele","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Rubini","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Sardaro","sequence":"additional","affiliation":[{"name":"Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"(2009). Special Issue: KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients. Am. J. Transplant., 9, S1\u2013S155.","DOI":"10.1111\/j.1600-6143.2009.02834.x"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jocd.2012.11.012","article-title":"Secondary and Tertiary Hyperparathyroidism","volume":"16","author":"Jamal","year":"2013","journal-title":"J. Clin. Densitom."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1097\/01.rlu.0000082672.49916.2b","article-title":"Prominent Tc-99m MIBI Skeletal Uptake in Renal Osteodystrophy: A Possible Role for Whole-Body Scanning","volume":"28","author":"Reczek","year":"2003","journal-title":"Clin. Nucl. Med."},{"key":"ref_4","first-page":"1289","article-title":"Bone scintigraphy in renal osteodystrophy","volume":"19","author":"Schicht","year":"1978","journal-title":"J. Nucl. 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Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1097\/RLU.0000000000002230","article-title":"Tertiary hyperparathyroidism with renal osteodystrophy on 18F-fluorocholine PET\/CT","volume":"43","author":"Broos","year":"2018","journal-title":"Clin. Nucl. Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/10\/851\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:24:43Z","timestamp":1760178283000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/10\/851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,20]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["diagnostics10100851"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics10100851","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,20]]}}}