The diagnostic value of dual-phase 99mTc-MIBI scintigraphy combined with SPECT/CT for primary hyperparathyroidism

Objectives To investigate the application and value of dual-phase 99mTc-MIBI scintigraphy combined with SPECT/CT for primary hyperparathyroidism compared with dual-phase 99mTc-MIBI scintigraphy alone.

Methods Forty patients with mean age (55.4±12.4) years who were suspected to have primary hyperparathyroidism, underwent dual-phase 99mTc-MIBI scintigraphy and dual-phase 99mTc-MIBI scintigraphy combined with SPECT/CT between April 2008 and December 2012. They were retrospectively reviewed. All patients had pathological diagnosis based on surgical resection. The dual-phase 99mTc-MIBI scintigraphy images were analyzed first which initially estimate the location of the lesions by two experienced nuclear medicine physicians, and SPECT/CT was then analyzed the location accurately. In comparison with the result of pathological diagnosis, the diagnostic ability of dual-phase 99mTc-MIBI scintigraphy images and SPECT/CT were evaluated. The diagnostic accuracy of 99mTc-MIBI scintigraphy images and dual-phase 99mTc-MIBI scintigraphy combined with SPECT/CT were calculated, and χ2test was used to compare the difference between them.

Results Among these pathological diagnosis, 33cases were parathyroid adenoma, 7cases were parathyroid hyperplasia. Using dual-phase 99mTc-MIBI scintigraphy alone and dual-phase 99mTc-MIBI scintigraphy combined with SPECT/CT for the differential diagnosis of primary hyperparathyroidism, the sensitivity, specificity, and accuracy were 55.81%(24/43) vs 81.40%(35/43),92.31%(108/117)vs94.87%(111/117),82.50%(132/160)vs91.25%(146/160), respectively. The difference between them was significant(χ2=1.13,P<0.01).

Conclusions Compared with dual-phase 99mTc-MIBI scintigraphy images alone, the diagnostic accuracy of dual-phase 99mTc-MIBI scintigraphy combined with SPECT/CT is significantly improved. The combination imaging is a kind of accurate and effective preoperative localization diagnosis method for primary hyperparathyroidism, it can improve the parathyroid adenoma diagnosis ability.