Comparison of SPECT/CT, MIBI Planar and Ultrasonography in diagnosis of hyperparathyroidism.

Objectives To compare the diagnostic value of ^99mTc-sestamibi (MIBI)single photon emission computed tomography/computerized tomography (SPECT/CT) , dual-phase planar scintigraphy and ultrasonography (US) of patients with hyperparathyroidism.


Methods A total of 78 patients were retrospectively recruited. Among them, nine were secondary hyperparathyroidism patients, six of them with ectopic parathyroid gland, and the rest were primary hyperparathyroidism patients. All of the enrolled patients received SPECT/CT, MIBI planar scintigraphy and ultrasonography examination. The sensitivity, specifity, accuracy and positive predictive value were compared among the three methods. Surgery, histological confirmation, post- and preoperative level of Ca and parathyroid hormone were the reference standard.

Results Fifty-two patients were clinlically diagnosed by the reference standard. Sensitivity and specificity for SPECT/CT, MIBI planar scintigraphy and ultrasonography were 86.54%, 88.46%, 78.85% as well as 88.46%, 92.31%, 80.77% respectively. The accuracy and positive predictive value were 87.18%, 89.74%, 79.49% as well as 93.75%, 95.83%, 89.13%. It shows that SPECT/CT and MIBI planar has advantages over ultrasonography in diagnosis both in sensitivity and specificity(P<0.05). However, the difference between SPECT/CT and MIBI planar scintigraphy has no statistical significance(P>0.05). Patients whose ultrasonography showed negative but isotope imaging positive were mainly ectopic parathyroid gland patients. Only two patients showed ultrasonography positive but MIBI planar negative , and one of them SPECT/CT was positive.

Conclusions For hyperparathyroidism, 99mTc-sestamibi SPECT/CT and MIBI planar have higher diagnostic value compared with ultrasonography. But there is no significant difference between SPECT/CT and MIBI planar.