REVIEW article
Front. Nucl. Med.
Sec. PET and SPECT
Volume 5 - 2025 | doi: 10.3389/fnume.2025.1645497
This article is part of the Research TopicMusculoskeletal Disorders Related to DysparathyroidismView all 5 articles
PET/CT Imaging of Bone Disorders in Dysparathyroidism: A Comprehensive Review
Provisionally accepted
Emmanouil Panagiotidis1
George Angelidis1*
VARVARA VALOTASSIOU1
Ioannis Tsougos1
Panagiotis Georgoulias1Jules Zhang-Yin2- 1Panepistemiako Geniko Nosokomeio Larisas, Larissa, Greece
- 2Cliniques du Sud Luxembourg, Arlon, Belgium
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Parathyroid disorders profoundly affect bone metabolism, often long before structural damage is apparent on conventional imaging. Positron emission tomography/computed tomography (PET/CT) has emerged as a transformative tool in dysparathyroidism, enabling visualization of early metabolic bone changes and accurate localization of parathyroid pathology. This review explores the pathophysiology of bone disease in hyper-and hypoparathyroidism and highlights the role of key PET radiotracers: fluorine‑18 sodium fluoride ([18F]NaF), fluorine‑18 fluorodeoxyglucose ([18F]FDG), fluorine‑18 fluorocholine ([18F]FCH), gallium‑68 prostate‑specific membrane antigen ([68Ga]PSMA). Distinct imaging patterns, such as the [18F]NaF "superscan" in secondary hyperparathyroidism and focal uptake in brown tumors, are discussed alongside tracer-specific strengths. Clinical applications including diagnosis, monitoring response to therapy, and prognostication are examined. We also consider emerging technologies such as artificial intelligence (AI)-assisted interpretation and positron emission tomography/magnetic resonance imaging (PET/MRI) fusion imaging. As PET/CT becomes more accessible, it is likely to play an increasingly central role in the early detection and personalized management of parathyroid-related bone disease.
Keywords: fluorine‑18 sodium fluoride ([18F]NaF), fluorine‑18 fluorodeoxyglucose ([18F]FDG), fluorine‑18 fluorocholine ([18F]FCH), gallium‑68 prostate‑specific membrane antigen ([68Ga]PSMA), Dysparathyroidism
Received: 11 Jun 2025; Accepted: 18 Sep 2025.
Copyright: © 2025 Panagiotidis, Angelidis, VALOTASSIOU, Tsougos, Georgoulias and Zhang-Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: George Angelidis, angelidis@protonmail.ch
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