¹⁸F-fluorocholine (¹⁸F-FCH) PET/CT is a promising and increasingly used scan technique in the preoperative imaging of parathyroid adenoma. Several acquisition methods have been evaluated in the literature, but the optimal image acquisition time point after administration of the tracer is still under debate. Methods: Patients who had hyperparathyroidism, underwent dual-time-point ¹⁸F-FCH PET/CT (image acquisition, 5 min; 60 min after injection), and had histologically proven pathologic parathyroid glands were retrospectively included in the study. Early and late images were compared both visually and quantitatively. Results: Sixty-four patients were included, and a total of 71 parathyroid glands were surgically removed. Visually, there were no differences between early and late images of hyperfunctioning parathyroid glands in 44 patients (69%); in 13 patients (20%), visualization on early images was better; in 6 patients (9%), visualization of hyperfunctioning glands was best on late images; and in 1 patient (2%), the lesion was exclusively visualized on late images. For the total cohort, there was a significant decrease in ¹⁸F-FCH uptake in the glands on late versus early time points (P = 0.001), but there was a significant increase in the ratio of parathyroid uptake to thyroid uptake (P = 0.037). The group of patients with better visualization on early images showed a decrease over time in both parathyroid uptake and the ratio of parathyroid uptake to thyroid uptake, significant in comparison to those in both the group with better visualization at later time points and the group in which visualization was similar at both time points (P values of 0.000–0.018). There were no significant differences in ¹⁸F-FCH uptake and the ratio of parathyroid uptake to thyroid uptake between the latter 2 groups (P values of 0.200–0.709). Conclusion: In most patients (89%), hyperfunctioning parathyroid glands were adequately visualized on early imaging; however, in a subset of patients (11%), such glands were best visualized at later time points. Therefore, we recommend the acquisition of dual-time-point images in parathyroid imaging with ¹⁸F-FCH PET/CT or the creation of an opportunity to acquire additional late images after review of early images when findings are inconclusive.

¹⁸ F-氟胆碱（¹⁸ F-FCH）PET / CT在甲状旁腺腺瘤的术前成像中是一种很有前途且越来越多使用的扫描技术。文献中已经评估了几种采集方法，但是在使用示踪剂后的最佳图像采集时间仍存在争议。方法：将患有甲状旁腺功能亢进症，接受双时间点¹⁸ F-FCH PET / CT（图像采集，注射后5分钟； 60分钟）并经组织学证实为病理性甲状旁腺的患者纳入研究。视觉和定量比较早期和晚期图像。结果：包括64例患者，并通过手术切除了总共71个甲状旁腺。视觉上，44例（69％）甲状旁腺功能亢进的早期和晚期影像之间无差异。在13例患者（占20％）中，早期图像的可视化效果更好；在6例患者（占9％）中，在晚期图像上可视化功能亢进的腺体最好。在1例患者中（2％），病变仅在晚期图像上可视化。就整个队列而言，晚期与早期相比，腺体中¹⁸ F-FCH的摄取量显着减少（P = 0.001），但是甲状旁腺摄取量与甲状腺摄取量的比率却显着增加（P= 0.037）。在早期图像上具有更好可视化的患者组显示，甲状旁腺摄取和甲状旁腺摄取与甲状腺摄取的比率均随时间下降，这与在较晚时间点和具有较高可视性的组中的两组相比均显着可视化在两个时间点都相似（P值为0.000–0.018）。后两组之间的¹⁸ F-FCH摄取量和甲状旁腺摄取量与甲状腺摄取量的比率无显着差异（P值为0.200-0.709）。结论：在大多数患者中（89％），在早期影像学检查中可以充分看到功能亢进的甲状旁腺。但是，在部分患者（11％）中，最好在以后的时间点对这些腺体进行可视化。因此，我们建议在甲状旁腺成像中使用¹⁸ F-FCH PET / CT采集双时间点图像，或者在发现尚无定论时，在检查早期图像后创造更多的后期图像获取机会。