Primary hyperparathyroidism (PHPT) is a common endocrine disorder, definitive treatment usually requiring surgical removal of the offending parathyroid glands. To perform focused surgical approaches, it is necessary to localize all hyperfunctioning glands. The aim of the study was to compare the efficiency of established conventional scintigraphic imaging modalities with emerging ¹⁸F-fluorocholine PET/CT imaging in preoperative localization of hyperfunctioning parathyroid glands in a larger series of PHPT patients. Methods: In total, 103 patients with PHPT were imaged preoperatively with ¹⁸F-fluorocholine PET/CT and conventional scintigraphic imaging methods, consisting of ^99mTc-sestamibi SPECT/CT, ^99mTc-sestamibi/pertechnetate subtraction imaging, and ^99mTc-sestamibi dual-phase imaging. The results of histologic analysis, as well as intact parathyroid hormone and serum calcium values obtained 1 d after surgery and on follow-up, served as the standard of truth for evaluation of imaging results. Results: Diagnostic performance of ¹⁸F-fluorocholine PET/CT surpassed conventional scintigraphic methods (separately or combined), with calculated sensitivity of 92% for PET/CT and 39%–56% for conventional imaging (65% for conventional methods combined) in the entire patient group. Subgroup analysis, differentiating single and multiple hyperfunctioning parathyroid glands, showed PET/CT to be most valuable in the group with multiple hyperfunctioning glands, with sensitivity of 88%, whereas conventional imaging was significantly inferior, with sensitivity of 22%–34% (44% combined). Conclusion: ¹⁸F-fluorocholine PET/CT is a diagnostic modality superior to conventional imaging methods in patients with PHPT, allowing for accurate preoperative localization.

原发性甲状旁腺功能亢进症（PHPT）是一种常见的内分泌失调，确定性治疗通常需要通过手术切除病变的甲状旁腺。为了执行集中的手术方法，必须定位所有功能亢进的腺体。这项研究的目的是比较已建立的常规闪烁显像方式与新兴的¹⁸ F-氟胆碱PET / CT显像在大量PHPT患者术前甲亢性甲状旁腺定位中的效率。方法：对103例PHPT患者术前用¹⁸ F-氟胆碱PET / CT和常规闪烁显像方法进行成像，包括^99m Tc-sestamibi SPECT / CT，^99mTc-sestamibi /高tech相减成像和^99m Tc-sestamibi双相成像。组织学分析的结果，以及术后1天和随访时获得的完整甲状旁腺激素和血清钙值，成为评估影像学结果的真实标准。结果：诊断性能为¹⁸F-氟胆碱PET / CT超越了常规闪烁显像方法（单独或联合使用），在整个患者组中，计算出的PET / CT敏感性为92％，常规成像为39％–56％（常规方法为65％）。亚组分析，区分单个和多个功能亢进的甲状旁腺，显示PET / CT在具有多个功能亢进的腺体组中最有价值，敏感性为88％，而常规显像显着次于，敏感性为22％–34％（44 ％合并）。结论： ¹⁸ F-氟胆碱PET / CT对PHPT患者的诊断方法优于传统的影像学检查方法，可实现准确的术前定位。