The value of ^99mTc-MIBI parathyroid imaging and ultrasound in parathyroid adenoma and parathyroid hyperplasia

Objectives: To evaluate the value of ^99mTc-MIBI parathyroid imaging and ultrasound in parathyroid adenoma and parathyroid hyperplasia, and to reveal the characteristics of ^99mTc-MIBI parathyroid imaging, serum PTH, serum calcium and phosphorus, weight and the longest diameter of lesion in parathyroid adenoma and parathyroid hyperplasia.

Methods: A retrospective study of ^99mTc-MIBI double-phase imaging in 187 hyperparathyroidism cases diagnosed by pathology in July 2011 to May 2017 was performed, 167 cases underwent ultrasonography, and 146 cases underwent ^99mTc-MIBISPECT/CT imaging. The diagnostic accuracy of ultrasound, ^99mTc-MIBI double-phase and ^99mTc-MIBI SPECT/CT imaging was compared between parathyroid adenoma and parathyroid hyperplasia, and the characteristics of ^99mTc-MIBI parathyroid imaging, serum PTH, serum calcium and phosphorus, weight and the longest diameter of lesion in parathyroid adenoma and hyperplasia was analyzed. Results: Based on patients, the sensitivity of ultrasound examination, ^99mTc-MIBI dual-phase and ^99mTc-MIBI SPECT/CT imaging is 90.70%, 97.78% and 100% in parathyroid adenoma, and was 93.55%, 90.85% and 93.10% in parathyroid hyperplasia, respectively. But based on lesions, the accuracy of ultrasound examination, ^99mTc-MIBI dual-phase and ^99mTc-MIBI SPECT/CT imaging in parathyroid adenoma was 78.4%, 86.8% and 96.9%, respectively, and the accuracy of ^99mTc-MIBI dual-phase imaging is higher than that of ultrasonography (x²=6.507, P=0.011); in parathyroid hyperplasia was 49.69%, 40.71% and 43.80%, respectively, and the accuracy of ultrasonography is higher than that of ^99mTc-MIBI dual-phase imaging (x²=5.940, P=0.015). Serum PTH and serum phosphorus were lower in parathyroid adenoma than in parathyroid hyperplasia (P<0.001), and the serum calcium, lesion size, weight and the longest diameter of lesion were significantly higher in parathyroid adenoma than in parathyroid hyperplasia (P<0.01). There was significantly different in EUR between parathyroid adenoma and parathyroid hyperplasia (P<0.05), but no significant difference in DUR and RI between parathyroid adenoma and parathyroid hyperplasia (P>0.05). Serum PTH is often < 1000 pg/ml in parathyroid adenoma, but usually > 1000 pg/ml in parathyroid adenoma. Conclusion: ^99mTc-MIBI dual-phase imaging, ^99mTc-MIBI SPECT/CT imaging and ultrasound have high value in the diagnosis of parathyroid adenoma, and ^99mTc-MIBI SPECT/CT imaging should be the first choice of parathyroid adenoma, and early SPECT/CT imaging is better than delayed. The value of three methods for parathyroid hyperplasia has a limited value, but compared to ^99mTc-MIBI parathyroid imaging, perhaps ultrasound has a slight reference value.