Detection of Recurrent Parathyroid Cancer Using 68Ga-Trivehexin PET/CT

A 53-year-old woman with a history of multiple surgeries due to recurrent parathyroid carcinoma (rPTC) presented with elevated serum parathyroid hormone (PTH) and ionized calcium (Ca) levels. While 18 F-FDG PET/CT showed no pathologic uptake and 99m Tc-MIBI SPECT/CT showed a suspicious uptake, 68 Ga-Trivehexin PET/CT revealed intense activity in the recurrent lesion, as well as mild activity in one of the newly detected, widespread lesions in both lungs, which was assessed as metastatic. This is the first case report demonstrating the potential role of 68 Ga-Trivehexin PET/CT in detecting recurrent PTC, highlighting the possibility of false-negative results with 18 F-FDG PET/CT and 99m Tc-MIBI scintigraphy.