The role of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in the detection of brown tumors: A case series

Abstract

We present two cases of chronic hemodialysis patients with suspicious lytic pelvic bone lesions in the context of secondary hyperparathyroidism (HPT). Bone biopsies were inconclusive. ¹⁸F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) scans revealed highly hypermetabolic lytic lacunar bone lesions scattered throughout the skeleton. Pathological ^99mTc-hexakismethoxy- isobutyl-isonitrile (^99mTc-MIBI) uptake in the cervical region suggested parathyroid tissue involvement, while whole-body ^99mTc-MIBI scintigraphy did not reveal pathological uptake. Brown tumors were strongly suspected based on clinical and laboratory evidence of HPT, ruling out malignancy. Our cases suggest the superior sensitivity of ¹⁸F-FDG PET/CT in detecting and characterizing brown tumors compared to whole-body ^99mTc-MIBI scintigraphy. This examination offers crucial insights into characterizing brown tumors based on morpho-metabolic criteria, minimizing inaccurate diagnosis of this pathological condition.

Keywords

Brown tumors / Positron emission tomography/computed tomography / ¹⁸F-fluorodeoxyglucose / Hyperparathyroidism

Acknowledgments

None.

Funding

None.

Conflict of interest

The authors declare that they have no competing interests.

Author contributions

Conceptualization: Ayoub Dribla, Yassir Ben Ameur

Investigation: Ayoub Dribla, Omar Ait Sahel

Methodology: Salah Nabih Oueriagli, Ayoub Dribla

Writing - original draft: Ayoub Dribla, Salah Nabih Oueriagli

Writing - review & editing: Salah Nabih Oueriagli, Abderrahim Doudouh

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this case series, formal consent to participate is not required.

Consent for publication

Written informed consent was obtained from the patients for publication of this case series and any accompanying images.

Availability of data

Authors make available to all scientists, documents described in the manuscript, including new software, databases, and all relevant raw data.

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