{"title":"A novel imaging approach in hyperparathyroidism: [68Ga]Ga-Trivehexin PET/CT.","authors":"Dilara Denizmen Zorba, Serkan Kuyumcu, Duygu Has Simsek, Emine Goknur Isik, Arzu Poyanli, Ayse Kubat Uzum, Fikret Buyukkaya, Semen Onder, Nihat Aksakal, Yalin Iscan, Zeynep Gozde Ozkan, Yasemin Sanli","doi":"10.1007/s00259-026-07965-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic performance of [68Ga]Ga-Trivehexin PET/CT for localizing hyperfunctioning parathyroid tissue in patients with primary hyperparathyroidism (PHPT) and to compare it with [99mTc]Tc-MIBI scintigraphy with SPECT/CT (MIBI scan).</p><p><strong>Methods: </strong>In this retrospective study, patients with biochemically confirmed PHPT underwent both MIBI scan and [68Ga]Ga-Trivehexin PET/CT. Patient- and lesion-based detection rates were compared between modalities. [68Ga]Ga-Trivehexin PET/CT was acquired at approximately 40 ± 20 min after injection; delayed imaging at 80 ± 20 min was performed in a subset. Dynamic PET imaging was performed in three patients. Quantitative parameters, including SUVmax and lesion-to-background ratios, were recorded. Clinically relevant subgroups, including MEN-1-associated PHPT and persistent disease after surgery, were assessed.</p><p><strong>Results: </strong>A total of 50 parathyroid-related lesions were evaluated in 38 patients. On patient-based analysis, MIBI scan and [68Ga]Ga-Trivehexin PET/CT correctly localized hyperfunctioning parathyroid tissue in 28 of 38 (74%) and 35 of 38 (92%) patients, respectively. On lesion-based analysis, [68Ga]Ga-Trivehexin PET/CT detected 49 of 50 lesions (98%), compared with 29 of 50 lesions (58%) detected by MIBI scan (P < 0.05). [68Ga]Ga-Trivehexin PET/CT demonstrated distinct focal uptake in 18 lesions with negative or equivocal MIBI findings. Dual-time-point imaging showed no significant differences in lesion SUVmax or lesion-to-background ratios between early and delayed scans. Dynamic imaging demonstrated a rapid increase in lesion contrast followed by a plateau, with no consistent improvement beyond approximately 25 min.</p><p><strong>Conclusion: </strong>[68Ga]Ga-Trivehexin PET/CT demonstrated higher detection rates than MIBI scan for localizing hyperfunctioning parathyroid tissue in PHPT, particularly in multiglandular and subcentimetric disease. Early acquisition appears sufficient, with limited added value of delayed imaging.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":" ","pages":"6651-6660"},"PeriodicalIF":7.6000,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-026-07965-5","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/6/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the diagnostic performance of [68Ga]Ga-Trivehexin PET/CT for localizing hyperfunctioning parathyroid tissue in patients with primary hyperparathyroidism (PHPT) and to compare it with [99mTc]Tc-MIBI scintigraphy with SPECT/CT (MIBI scan).
Methods: In this retrospective study, patients with biochemically confirmed PHPT underwent both MIBI scan and [68Ga]Ga-Trivehexin PET/CT. Patient- and lesion-based detection rates were compared between modalities. [68Ga]Ga-Trivehexin PET/CT was acquired at approximately 40 ± 20 min after injection; delayed imaging at 80 ± 20 min was performed in a subset. Dynamic PET imaging was performed in three patients. Quantitative parameters, including SUVmax and lesion-to-background ratios, were recorded. Clinically relevant subgroups, including MEN-1-associated PHPT and persistent disease after surgery, were assessed.
Results: A total of 50 parathyroid-related lesions were evaluated in 38 patients. On patient-based analysis, MIBI scan and [68Ga]Ga-Trivehexin PET/CT correctly localized hyperfunctioning parathyroid tissue in 28 of 38 (74%) and 35 of 38 (92%) patients, respectively. On lesion-based analysis, [68Ga]Ga-Trivehexin PET/CT detected 49 of 50 lesions (98%), compared with 29 of 50 lesions (58%) detected by MIBI scan (P < 0.05). [68Ga]Ga-Trivehexin PET/CT demonstrated distinct focal uptake in 18 lesions with negative or equivocal MIBI findings. Dual-time-point imaging showed no significant differences in lesion SUVmax or lesion-to-background ratios between early and delayed scans. Dynamic imaging demonstrated a rapid increase in lesion contrast followed by a plateau, with no consistent improvement beyond approximately 25 min.
Conclusion: [68Ga]Ga-Trivehexin PET/CT demonstrated higher detection rates than MIBI scan for localizing hyperfunctioning parathyroid tissue in PHPT, particularly in multiglandular and subcentimetric disease. Early acquisition appears sufficient, with limited added value of delayed imaging.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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