A Pilot Study of the Utility of Amino Acid Transport Imaging of Parathyroid Adenomas with anti-3[18F] FACBC

Hyperparathyroidism is an increasingly significant medical and public health condition. The most common technique for preoperative localization is a SPECT/CT, utilizing Tc-99m-sestamibi (MIBI) as a radiotracer.  However, the reported sensitivity and specificity is only 80%. Thus, there is a need for more accurate preoperative localization of parathyroid adenomas. Anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid (anti-3-[18F]FACBC) is a synthetic amino acid analog for positron emission tomography (PET), which has demonstrated promise for the staging and restaging of prostate carcinoma. Preliminary data suggesting that amino acid transport may be upregulated in parathyroid adenomas and hyperplasia. In this pilot study 12 patients who are scheduled for surgery after standard preoperative evaluation for biochemically confirmed hyperparathyroidism will undergo anti-3-[18F] FACBC PET-CT. Uptake within the parathyroid gland will be measured and compared against available standard imaging such as dual phase sestamibi SPECT-CT. Truth will be validated by reported histology, Results of this pilot study will be used to possibly design larger and more comprehensive studies examining clinical utility.

Funding Agency: Internal
PI: David M Schuster, MD

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