18F FCH PET/CT in pHPT
Research type
Research Study
Full title
Optimising dose, protocols and the use of Choline PET/CT in the assessment of parathyroid adenomas
IRAS ID
321200
Contact name
Karen Knapp
Contact email
Sponsor organisation
University of Exeter
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Primary hyperparathyroidism is a common endocrine disorder. The definitive cure is the surgical removal of the affected gland; usually carried out by minimally invasive parathyroidectomy (MIP). Preoperative imaging is needed to localise the affected gland to be removed. The accurate identification of the hyperfunctioning gland is essential for successful surgery. The conventional imaging modalities recommended by NICE guidelines are Ultrasound and/or Nuclear Scintigraphy. However, both modalities have shown limitations in some patients groups and sensitivity is decreased in small size glands. Another imaging modality that is routinely used is four-dimensional computed tomography (4D-CT) which shows better diagnostic capabilities. However, it has more radiation burden and is contraindicated in some cases. Currently, patients have 2 scans of the mentioned three modalities (US, Nuclear scintigraphy, and 4D-CT) to colocalise the affected gland before surgery.
FCH PET/CT is a powerful diagnostic tool in identifying adenomas as a first line imaging as well as a second-line imaging after negative or inconclusive conventional imaging results. Several studies demonstrated it has superior diagnostic value. The advantageous spatial resolution of PET/CT allow the detection of smaller lesions which could be missed by other imaging modalities. However, two CT scans are currently needed increasing the radiation burden.
Our aim is to optimise the FCH protocol and dose using dynamic PET/CT scan.
We aim to optimise the protocol by the following:
1- Reducing the PET scan period. Currently, it takes up to 1 hour.
2- Reducing the radiation dose of the radioisotope (18F FCH) and the CT part by performing one scan instead of two. This reduces the overall radiation exposure to the patient
This study seeks the recruitment of 22 patients who have been diagnosed with pHPT and awaiting surgery. They will be scanned with PET/CT using F18- Flouro choline as a radiotracer.REC name
North of Scotland Research Ethics Committee 2
REC reference
24/NS/0094
Date of REC Opinion
11 Aug 2024
REC opinion
Favourable Opinion