{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:32:17Z","timestamp":1792715537295,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T00:00:00Z","timestamp":1680912000000},"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>Hyperparathyroidism (HPT) in patients with chronic kidney disease (CKD) includes secondary (sHPT) and tertiary hyperparathyroidism (tHPT). Considering that the role of preoperative imaging in the clinical setting is controversial, in the present study we have retrospectively compared pre-surgical diagnostic performances of 18F-Fluorocholine (18F-FCH) PET\/CT, cervical ultrasonography (US), parathyroid scintigraphy, and 4D-CT in a group of 30 patients with CKD and HPT (18\/12 sHPT\/tHPT), 21 CKD G5 including 18 in dialysis, and 9 kidney transplant recipients. All patients underwent 18F-FCH, and 22 had cervical US, 12 had parathyroid scintigraphy, and 11 had 4D-CT. Histopathology was the gold standard. Seventy-four parathyroids were removed: 65 hyperplasia, 6 adenomas, and 3 normal glands. In the whole population, in a per gland analysis, 18F-FCH PET\/CT was significantly more sensitive and accurate (72%, 71%) than neck US (25%, 43%), parathyroid scintigraphy (35%, 47%), and 4D-CT (40%, 47%). The specificity of 18F-FCH PET\/CT (69%) was lower than that of neck US (95%) and parathyroid scintigraphy (90%), without, however, achieving significance. 18F-FCH PET\/CT was more accurate than all other diagnostic techniques when sHPT and tHPT patients were considered separately. 18F-FCH PET\/CT sensitivity was significantly higher in tHPT (88%) than in sHPT (66%). Three ectopic hyperfunctioning glands (in three different patients) were all detected by 18F-FCH PET\/CT, two by parathyroid scintigraphy, and none by cervical US and 4D-CT. Our study confirms that 18F-FCH PET\/CT is an effective preoperative imaging option in patients with CKD and HPT. These findings may be of greater importance in patients with tHPT (who could benefit from minimally invasive parathyroidectomy) than in patients with sHPT, who often undergo bilateral cervicotomy. In these cases, preoperative 18F-FCH PET\/CT may be helpful in locating ectopic glands and may guide the surgical choice for gland preservation.<\/jats:p>","DOI":"10.3390\/diagnostics13081374","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T03:15:57Z","timestamp":1681096557000},"page":"1374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["18F-Fluorocholine PET\/CT Compared with Current Imaging Procedures for Preoperative Localization of Hyperfunctioning Parathyroids in Patients with Chronic Kidney Disease"],"prefix":"10.3390","volume":"13","author":[{"given":"Samuel","family":"Aymard","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University of Strasbourg, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Leroy-Freschini","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University of Strasbourg, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashjan","family":"Kaseb","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University of Strasbourg, 67200 Strasbourg, France"},{"name":"Department of Radiology, College of Medicine, University of Jeddah, Jeddah 23890, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5804-671X","authenticated-orcid":false,"given":"David","family":"Marx","sequence":"additional","affiliation":[{"name":"Department of Medicine C, H\u00f4pital de S\u00e9lestat, 67600 S\u00e9lestat, France"},{"name":"Department of Nephrology and Transplantation, Strasbourg University Hospitals, University of Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Helali","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University of Strasbourg, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerlinde","family":"Averous","sequence":"additional","affiliation":[{"name":"Department of Pathology, Strasbourg University Hospitals, University of Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Betz","sequence":"additional","affiliation":[{"name":"Department of Nephology, H\u00f4pital de Colmar, 68024 Colmar, France"},{"name":"AURAL Dialysis Center, 68000 Colmar, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Riehm","sequence":"additional","affiliation":[{"name":"Department of Radiology, Strasbourg University Hospitals, 67098 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9303-2364","authenticated-orcid":false,"given":"Michel","family":"Vix","sequence":"additional","affiliation":[{"name":"Department of General, Digestive, and Endocrine Surgery, IRCAD-IHU, Strasbourg University Hospitals, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7343-5943","authenticated-orcid":false,"given":"Peggy","family":"Perrin","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, Strasbourg University Hospitals, University of Strasbourg, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Imperiale","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging, Institut de Canc\u00e9rologie de Strasbourg Europe (ICANS), University of Strasbourg, 67200 Strasbourg, France"},{"name":"Department of General, Digestive, and Endocrine Surgery, IRCAD-IHU, Strasbourg University Hospitals, 67000 Strasbourg, France"},{"name":"Molecular Imaging\u2014DRHIM, IPHC, UMR 7178, CNRS, University of Strasbourg, 67093 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1177\/1457496919866015","article-title":"Secondary and Tertiary Hyperparathyroidism: A Narrative Review","volume":"109","author":"Noltes","year":"2020","journal-title":"Scand. 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