We aimed to assess the value of ¹¹C-choline PET in patients with primary hyperparathyroidism and negative or discordant results on ^99mTc-sestamibi imaging and neck ultrasound. Methods: Eighty-seven such patients were assessed and subsequently underwent parathyroidectomy. PET/CT image data were analyzed semiquantitatively using SUV_max and SUV ratios (target to contralateral thyroid gland and carotid artery). A positive PET/CT result was defined as focal uptake significantly higher than regular thyroid tissue. Ectopic foci were also considered positive. Inconclusive PET/CT cases were defined as a lesion with uptake equal to normal thyroid tissue. If no prominent or ectopic uptake was detectable, the PET/CT result was considered negative. Results: When dichotomizing the ¹¹C-choline PET/CT imaging results by defining lesions with both positive and inconclusive uptake as positive, we found 84 of 92 lesions (91.3%) to have true-positive uptake whereas 8 lesions (8.7%) had false-positive uptake. One lesion showed false-negative uptake; the sensitivity was 98.8%. The corresponding positive predictive value for lesions was 91.3%. The mean SUV_max was 6.15 ± 4.92 in 72 lesions with positive uptake (70 patients) and 2.96 ± 2.32 in 20 lesions with inconclusive uptake (18 patients). Conclusion: These results in a large group of patients indicate that ¹¹C-choline PET/CT is a promising tool for parathyroid adenoma localization when ultrasound and ^99mTc-sestamibi imaging yield negative or discordant results.

我们旨在评估¹¹ C胆碱PET在原发性甲状旁腺功能亢进且^99m Tc-司他他比成像和颈部超声检查结果阴性或不一致的患者中的价值。方法：对87名此类患者进行了评估，随后进行了甲状旁腺切除术。使用SUV _max对PET / CT图像数据进行半定量分析和SUV比（针对对侧甲状腺和颈动脉）。PET / CT阳性结果定义为局灶摄取明显高于正常甲状腺组织。异位灶也被认为是阳性的。尚无定论的PET / CT病例定义为摄取量与正常甲状腺组织相等的病变。如果未检测到明显或异位摄取，则认为PET / CT结果为阴性。结果：将¹¹分时C-胆碱PET / CT成像结果通过将阳性和不确定摄取的病变定义为阳性，我们发现92个病变中的84个（91.3％）具有真阳性摄取，而8个病变（8.7％）具有假阳性摄取。一处病灶显示假阴性摄取。灵敏度为98.8％。相应的病变阳性预测值为91.3％。SUV阳性的72个病灶（70例患者）的平均SUV _max为6.15±4.92，20例不确定的肠胃病（18例）中的SUV平均值为2.96±2.32。结论：在大量患者中的这些结果表明，当超声和^99m Tc-司他他比成像产生阴性或不一致的结果时，¹¹ C-胆碱PET / CT是甲状旁腺腺瘤定位的有前途的工具。