Parathyroid gland detection in hyperparathyroidism with 18F-fluorocholine PET/CT

Accurate preoperative localization of hyperfunctioning parathyroid glands is important in patients with hyperparathyroidism who are planned for parathyroidectomy, especially since minimally invasive surgical procedures are regularly used nowadays. An upcoming imaging technique to localize hyperfunctioning parathyroid glands is PET/CT with 18F-fluorocholine (18F-FCH). In this thesis, several both technical as well as clinical aspects of this relatively new imaging method were studied. The current scientific literature related to 18F-FCH PET/CT was reviewed, which showed favorable results for this technique. Different scan acquisition protocols such as dual-time-point scanning and dynamic scanning were studied, which contributed to further optimalization of acquisition protocols. Furthermore, the incidence and relevance of incidental findings on 18F-FCH PET/CT were studied, and in a retrospective cohort study it was concluded that 18F-FCH PET/CT is an excellent imaging technique to detect hyperfunctioning parathyroid glands, not only in case conventional imaging methods are inconclusive, but also as a first-line imaging modality.