Dynamic(18)F-fluorocholine PET/CT for parathyroid imaging in patients with primary hyperparathyroidism

Wouter A. M. Broos*, Maurits Wondergem, Friso M. van der Zant, Nicolaas C. Schaper, Remco J. J. Knol

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective In the past few years,F-18-fluorocholine PET/CT has been established as a promising imaging technique for preoperative localization of parathyroid adenomas, but the optimal time point to start PET/CT acquisition after tracer injection is yet unknown. The aim of the present study was to assess the optimal time frame to acquire the PET/CT images and to evaluate the ability of dynamic imaging to differentiate parathyroid adenomas from active lymph nodes, a common cause for false-positive scan results. Patients and methods Patients with primary hyperparathyroidism who had undergone a dynamic(18)F-fluorocholine PET/CT positive for parathyroid disease and who subsequently underwent successful parathyroidectomy were retrospectively included in this study. On the 20 minutes dynamic images, standardized uptake value measurements were acquired per 1 minute frame for the parathyroid adenoma, the thyroid gland, blood pool activity, and, if present, lymph node activity. Results A total of 101 patients were included in this study. Time-activity curves showed a decrease of activity in parathyroid and thyroid glands, with faster wash-out from the thyroid gland and on average a stable, lower activity in lymph nodes. Blood pool activity was particularly present in the first 2 minutes. Differentiation of a parathyroid adenoma from active lymph nodes was best before 5 minutes, but no definitive cutoff value could be determined. Differentiation of a parathyroid adenoma from the thyroid gland was best after 10 minutes. Conclusion Dynamic imaging starting at the early time point of 2 minutes after injection of(18)F-fluorocholine is useful for characterization of hyperfunctioning parathyroid glands.

Original languageEnglish
Pages (from-to)776-782
Number of pages7
JournalNuclear Medicine Communications
Issue number8
Publication statusPublished - Aug 2020


  • F-18-fluorocholine
  • dynamic scanning
  • hyperparathyroidism
  • PET
  • CT
  • C-11-CHOLINE

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