Page 109 - ARNM-3-1

Advances in Radiotherapy
& Nuclear Medicine Role of 18F-FDG in brown tumor detection

foci are sometimes symmetrical, distinguishing them Writing – review & editing: Salah Nabih Oueriagli,
from osseous metastases, which are, by nature, randomly Abderrahim Doudouh
distributed throughout the skeleton. Despite these
morpho-metabolic criteria, it is impossible to definitively Ethics approval and consent to participate
rule out the neoplastic origin of these lacunar foci, and All procedures performed in studies involving human
histological methods remain the only guarantee to confirm participants were in accordance with the ethical standards
the diagnosis of brown tumors. Sometimes, in the face of of the institutional and/or national research committee
repeated bone biopsies free of malignancy, the convergence and with the 1964 Helsinki Declaration and its later
of clinical-biological arguments related to secondary HPT amendments or comparable ethical standards. For this
and the morpho-metabolic aspect of these tumors are case series, formal consent to participate is not required.
sufficient for clinicians to diagnose brown tumors. 2
In our cases, parathyroid scintigraphy complemented Consent for publication
by whole-body scanning did not show clear pathological Written informed consent was obtained from the patients
uptake of 99m Tc-MIBI outside the usual sites of cervical for publication of this case series and any accompanying
and/or mediastinal uptake: Bone sites suspected of images.
being brown tumors. Similarly, bone scintigraphy with
radiobiphosphonates performed for diagnostic purposes Availability of data
in the neoplastic context failed to highlight these lytic Authors make available to all scientists, documents
foci. This suggests that both methods lack the sensitivity
to detect multiple brown tumors scattered throughout the described in the manuscript, including new software,
axial and peripheral skeleton. Our two clinical cases thus databases, and all relevant raw data.
suggest that F-FDG PET/CT may be more sensitive for References
18
detecting bone lesions in the context of brown tumors than
whole-body 99m Tc-MIBI scintigraphy. This examination 1. Ullah E, Ahmad M, Ali SA, Redhu N. Primary
provides key insights into characterizing brown tumors hyperparathyroidism having multiple Brown tumors
based on morpho-metabolic criteria, minimizing mimicking malignancy. Indian J Endocrinol Metab.
inaccurate diagnosis of pathological condition. 2012;16:1040-1042.
doi: 10.4103/2230-8210.103037
4. Conclusion
2. Penhaat MG, Drui D, Ansquer C, Mirallie E, Maugars Y,
The two clinical cases we present are consistent with other Guillot P. Contribution of FDG PET/CT for the detection
18
cases reported in the literature, suggesting the superiority of brown tumors in a case of primary hyperparathyroidism.
of F-FDG PET/CT for the detection of brown tumors Rhum Rev. 2016;83:386.389.
18
compared to whole-body 99m Tc-MIBI scintigraphy and/or doi: 10.1016/j.rhum.2016.05.013
bone scintigraphy with radiobiphosphonates. Histological
methods remain the reference to confirm the diagnosis 3. Tsukamoto S, Kawabata K, Kawamura H, Takata K,
Hosono M. Differentiating brown tumor from bone
and rule out a neoplastic origin of these lytic foci.
metastasis in parathyroid cancer using 18F-FDG PET and
Acknowledgments 99mTc-MIBI SPECT. Clin Nucl Med. 2024;49(5):444-446.
doi: 10.1097/RLU.0000000000005115
None.
4. Greilsamer T, Blanchard C, Christou N, et al. Management
Funding of thyroid nodules incidentally discovered on MIBI scanning
for primary hyperparathyroidism. Langenbecks Arch Surg.
None.
2015;400:313-318.
Conflict of interest doi: 10.1007/s00423-015-1286-y

The authors declare that they have no competing interests. 5. Santiago Chinchilla A, Ramos Font C, Muros de
Fuentes MA, et al. False negative of the scintigraphy with
Author contributions 99mTc-sestamibi in parathyroid carcinoma with associated
brown tumors. Contributions of the 18F-FDG-PET/CT. Rev
Conceptualization: Ayoub Dribla, Yassir Ben Ameur Esp Med Nucl. 2011;30:174-179.
Investigation: Ayoub Dribla, Omar Ait Sahel
Methodology: Salah Nabih Oueriagli, Ayoub Dribla doi: 10.1016/j.remn.2010.08.006
Writing – original draft: Ayoub Dribla, Salah Nabih Oueriagli 6. Zhao Y, Wang Q. Bone uptake of Tc-99m MIBI in patients

Volume 3 Issue 1 (2025) 101 doi: 10.36922/arnm.3540