18 Fluorocholine Positron Emission Tomography/Computed Tomography in the Localization of Culprit Lesions in Patients of Persistent/Recurrent Primary Hyperparathyroidism in COVID Times: Comment

Dear Editor,

We would like to comment on “Role of 18fluorocholine positron emission tomography/computed tomography in the localization of culprit lesions in patients of persistent/recurrent primary hyperparathyroidism: A prospective study in COVID times.[1]” The purpose of this prospective study was to see how successful 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) was as a diagnostic tool for identifying aberrant parathyroid tissue in recurrent/persistent primary hyperparathyroidism. The findings of 18F-FCH PET/CT with 99mTc-Sestamibi dual-phase scintigraphy, early single-photon emission CT/CT, and neck ultrasonography were compared in the study. The study included 20 individuals, and the imaging results were used to pinpoint parathyroid lesions. Six patients had surgery to remove the lesions that were discovered, 3 were awaiting surgery, and 11 were handled conservatively. Unfortunately, one patient died as a result of COVID.

The study only included 20 participants, which may restrict the findings’ generalizability. It is difficult to verify the accuracy and reliability of 18F-FCH PET/CT for preoperative localization of aberrant parathyroid tissue without a control group or comparison to an established gold standard test. The study did not go into enough detail about how the imaging results were interpreted or the criteria utilized to identify aberrant parathyroid tissue.

To give a more comprehensive evaluation of the value of 18F-FCH PET/CT, future studies should include a greater number of individuals and a control group. To establish the most effective diagnostic strategy, the next study should compare the efficacy of 18F-FCH PET/CT with other imaging modalities such as magnetic resonance imaging or CT. To evaluate clinical results and the long-term usefulness of 18F-FCH PET/CT in guiding treatment decisions for recurrent/persistent primary hyperparathyroidism, patients should be followed up with over a longer period of time.