Additional value of integrated 18 F-choline PET/4D contrast-enhanced CT in the localization of hyperfunctioning parathyroid glands and correlation with molecular profile

Purpose The localization of hyperfunctioning parathyroid gland(s) (HPTG) in patients with primary hyperparathyroidism(PHPT) with negative or inconclusive first-line imaging is a significant challenge. This study aimed to evaluate the role of integrated 18F- cholinePET/4D contrast-enhanced computed tomography (4DCeCT) in these patients, compare its detection rate and sensitivity with those of 18F- cholinePET/CT and (4DCeCT), and analyse the association between cholinemetabolism and morphological, biochemical and molecular parameters of HPTG.