FDG-anorectic parathyroid carcinoma with FDG-avid bone metastasis on PET/CT images

Detection of Recurrent Parathyroid Cancer Using 68Ga-Trivehexin PET/CT

A 53-year-old woman with a history of multiple surgeries due to recurrent parathyroid carcinoma (rPTC) presented with elevated serum parathyroid hormone (PTH) and ionized calcium (Ca) levels. While 18F-FDG PET/CT showed no pathologic uptake and 99mTc-MIBI SPECT/CT showed a suspicious uptake, 68Ga-Trivehexin PET/CT revealed intense activity in the recurrent lesion, as well as mild activity in one of the newly detected, widespread lesions in both lungs, which was assessed as metastatic. This is the first case report demonstrating the potential role of 68Ga-Trivehexin PET/CT in detecting recurrent PTC, highlighting the possibility of false-negative results with 18F-FDG PET/CT and 99mTc-MIBI scintigraphy.

Detection of Muscular Metastasis in a Case of Parathyroid Carcinoma Using 18 F-FAPI-04 PET/CT

ABSTRACT

A 46-year-old woman underwent surgery for parathyroid carcinoma 2 years ago. During follow-up, the patient presented with elevated parathyroid hormone (127.50 pg/mL; normal, 15-65). No abnormal uptake of 18 F-FDG or 11 C-choline was observed on 18 F-FDG and 11 C-choline PET/CT imaging. The patient was enrolled in a clinical trial for 18 F-FAPI PET/CT imaging, revealing a lesion with intense focal uptake within the left sternocleidomastoid muscle. The patient underwent surgery. Postoperative pathology and immunohistochemical analysis confirmed parathyroid carcinoma metastasis.

A Case of Brown Tumor on 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT

ABSTRACT

A 50-year-old man presented with right chest pain and persistent increased parathyroid hormone after parathyroidectomy for parathyroid carcinoma. 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT were performed consecutively for restaging to determine subsequent treatment strategy. An osteolytic lesion on the right sixth rib showed increased uptake on both 68Ga-DOTATATE and 18F-FDG PET/CT. Subsequent biopsy confirmed it to be a brown tumor.

Parathyroid Carcinoma - A Malignant Cause of Metabolic Skeletal Super Scan on Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography

Excessive abnormal tracer uptake in active tracer avid organ(s) with the suppression of physiological background tracer distribution is termed as super scan. Herein, we present an ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT), where the metabolic pattern of skeletal super scan with coexistent parathyroid tumor was seen giving rise to the suspicion of primary hyperparathyroidism. It was subsequently diagnosed as a case of parathyroid carcinoma. Very high levels of serum parathormone in parathyroid carcinoma lead to accelerated bone turn over resulting in metabolic skeletal superscan in FDG-PET/CT which is seldom observed in parathyroid adenoma.

Circulating Tumor Cell Analysis in Preclinical Mouse Models of Metastasis

The majority of cancer deaths occur because of metastasis since current therapies are largely non-curative in the metastatic setting. The use of in vivo preclinical mouse models for assessing metastasis is, therefore, critical for developing effective new cancer biomarkers and therapies. Although a number of quantitative tools have been previously developed to study in vivo metastasis, the detection and quantification of rare metastatic events has remained challenging. This review will discuss the use of circulating tumor cell (CTC) analysis as an effective means of tracking and characterizing metastatic disease progression in preclinical mouse models of breast and prostate cancer and the resulting lessons learned about CTC and metastasis biology. We will also discuss how the use of clinically-relevant CTC technologies such as the CellSearch® and Parsortix™ platforms for preclinical CTC studies can serve to enhance the study of cancer biology, new biomarkers, and novel therapies from the bench to the bedside.