Value of 99mTc-MIBI SPECT/CT in pre-operative diagnosis of primary hyperparathyroidism

doi:10.3969/j.issn.1006-7795.2022.06.007

Abstract

Abstract: Objective To evaluate the clinical value of ^99mTc-sestamibi (^99mTc-MIBI) single photon emission computed tomography (SPECT)/computed tomography (CT) in preoperative diagnosis of primary hyperparathyroidism (PHPT) by comparing with ^99mTc-MIBI dualphase planar imaging and ultrasonography. Methods　A total of 101 patients (23 males, 78 females, 14-74 yearsold) who had received parathyroidectomy from Xuanwu Hospital, Capital Medical University were enrolled into this retrospective study. The pathological results were considered as the gold standard. The diagnostic efficiencies (sensitivity, specificity, accuracy, positive predictive value, and negative predictive value) of ^99mTc-MIBI SPECT/CT were compared with ^99mTc-MIBI dual-phase planar imaging and ultrasound examination using χ2 test. The size of positive lesions was compared with negative lesions in ^99mTc-MIBI SPECT/CT and 99mTc-MIBI dual-phase planar imaging usingt test respectively. Results　A total of 120 PHPT lesions were found in 101 patients, of which 93 cases had single lesion and 8 cases had multiple lesions, and 120 lesions included 89 parathyroid adenomas (8 ectopic adenomas), 5 atypical adenomas, 24 hyperplastic lesions (3 ectopic lesions), and 2 parathyroid carcinomas. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ^99mTc-MIBI SPECT/ CT for PHPT were 90.00%,99.64%,96.78%,99.08%, and 95.93% respectively. The corresponding results of dual-phase planar imaging were 76.67%,99.30%,92.57%,97.87%, and 90.97% respectively. The corresponding results of ultrasound examination were 82.50%,99.64%,94.55%,99.00%, and 93.09% respectively. The sensitivity (χ2 =14.062, P<0.001), accuracy (χ2=15.059, P<0.001), and negative predictive value (χ2=6.034, P<0.05) of ^99mTc-MIBI SPECT/CT for PHPT were higher than those of planar imaging. In contrast there were no significant differences in sensitivity and accuracy between ^99mTc-MIBI SPECT/CT and ultrasound examination (P>0.05). The maximum diameters of positive lesions of SPECT/CT and planar imaging were (1.90±0.98)cm and (2.01±0.99)cm, respectively, which were significantly larger than those of negative lesions (1.36±0.54) cm and (1.25±0.67) cm (t=2.311,3.827, both P<0.05), respectively. Conclusion There were higher sensitivity, accuracy, and negative predictive value of ^99mTc-MIBI SPECT/CT in the diagnosis of PHPT, which has important clinical application value in preoperative localization and qualitative diagnosis of PHPT.

Key words: hyperparathyroidism, primary, single photon emission computed tomography/computed tomography, sestamibi

CLC Number:

Wang Man, Hou Yaqin, Cui Bixiao, Bi Sheng, Wang Bojun, Zhang Chun, Lu Jie. Value of ^99mTc-MIBI SPECT/CT in pre-operative diagnosis of primary hyperparathyroidism[J]. Journal of Capital Medical University, 2022, 43(6): 861-866.

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Value of ^99mTc-MIBI SPECT/CT in pre-operative diagnosis of primary hyperparathyroidism

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