[18F-fluorocholine PET-CT scan effective in localising pathological parathyroid glands]

18F-fluorocholine PET-CT was introduced in The Netherlands for detection of pathological parathyroid glands in patients with primary and secondary hyperparathyroidism around five years ago. This relatively new imaging technique is able to localise pathological parathyroid glands in the case of negative or inconclusive conventional imaging, such as ultrasound and 99mTc-sestamibi scans. In this manuscript we review the performance and usage of 18F-fluorocholine PET-CT in the Netherlands. In the past five years many articles have been published, demonstrating its superior sensitivity and positive predictive value. All centers in The Netherlands have adopted this scan in their daily practice to enable minimal invasive surgery in patients with hyperparathyroidism, due to the relatively high costs, mostly as second line imaging modality. Studies regarding cost-effectiveness are currently lacking and will have to show if this new imaging modality should replace 99mTc-sestamibi scanning as a first-line localisation study.