Respiratory gating in [18F]fluorocholine PET/CT for hyperparathyroidism: a quantitative proof-of-concept study

BACKGROUND: The effect of breathing on the [18F]fluorocholine parathyroid uptake profile has not been yet evaluated. The main objective of our study is to assess the technical feasibility of respiratory-gated [18F]fluorocholine PET/CT in patients with hyperparathyroidism. Specifically, we aimed to investigate whether respiratory motion correction has a measurable impact on quantitative PET parameters compared to free-breathing PET in a cohort of patients with clearly identifiable hypermetabolic parathyroid lesions.METHODS: Respiratory-gated [18F]fluorocholine PET/CT was performed using a pressure-sensitive belt placed around the thorax. An elliptic volume of interest was drawn on each hyperfunctioning parathyroid on both respiratory-gated and free-breathing PET scans, and SUVmax and SUVpeak were measured. An image profile was drawn across hypermetabolic targets on the coronal view, and full-width-at-half-maxima (FWHM) of glandular uptake profile was calculated. Wilcoxon signed-rank test and Mann-Whitney U-test were used for intragroup and intergroup comparison, respectively. A P value