68Ga-Trivehexin Uptake in Brown Tumors in Hyperparathyroidism

We present a 54-year-old woman with chronic kidney disease, hypercalcemia, and hyperparathyroidism, who exhibited multiple osteolytic lesions and a suspicious parathyroid adenoma. 18 F-FDG PET/CT revealed increased metabolic activity in the lytic lesions, raising suspicion for multiple myeloma or brown tumors. A biopsy confirmed brown tumors. Subsequent 68 Ga-Trivehexin PET/CT showed intense αvβ6-integrin expression in the parathyroid adenoma and moderate uptake in the brown tumors. This highlights the potential utility of 68 Ga-Trivehexin in the characterization of osteolytic lesions in hyperparathyroidism.