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Diagnosis performance of 99mTc-MIBI and multimodality imaging for hyperparathyroidism

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Summary

This study aimed to examine the diagnosis performance of 99mTc-methoxyisobutylisonitrisonitrile (99mTc-MIBI) and multimodality imaging [ultrasound, single-photon emission computed tomography/computed tomography (SPECT/CT)] for hyperparathyroidism (HPT). From Nov. 2009 to Dec. 2015, clinical data of a total of 43 HPT patients (16 males and 27 females; 26–70 years old, average age: 51.60±10.66 years old) were retrospectively analyzed. Among them, 19 patients with primary hyperparathyroidism (PHPT) underwent 99mTc-MIBI planar imaging, 24 [15 with PHPT and 9 with secondary hyperparathyroidism (SHPT)] underwent SPECT/CT hybrid imaging, and 41 (33 with PHPT and 8 with SHPT) had neck ultrasound imaging. Final diagnosis was determined by pathological examination after surgery. The positive rate was compared between different imaging modalities, and the correlation analysis was conducted between imaging results and lesion size or serum parathyroid hormone (PTH) level. The results showed that the total positive rates of 99mTc-MIBI imaging, ultrasound, and the two combined imaging in the 43 HPT cases were 90.70% (39/43), 58.54% (24/41), and 100% (41/41), respectively. According to lesion numbers, the positive rates were 79.10% (53/67), 53.23% (33/62), and 88.71% (55/62), respectively. SPECT/CT hybrid images were positive in all the 24 patients who underwent this examination. The mean maximum diameters of the lesions in 99mTc-MIBI positive and negative patients were 1.96±0.95 cm and 1.36±0.67 cm respectively, with statistically significant difference noted (P=0.03). The T/NT of 99mTc-MIBI imaging at the early phase was correlated positively with serum PTH level (r=0.40, P=0.01). The T/NT of 99mTc-MIBI imaging at both the early phase and the delay phase was correlated positively with lesion size (r=0.51, and r=0.45, respectively; P<0.01 for both). It was concluded that 99mTc-MIBI imaging presents significant value for location diagnosis of HPT, especially when combined with SPECT/CT hybrid imaging or ultrasound. The 99mTc-MIBI uptake correlates positively with serum PTH level and lesion size.

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References

  1. Dong JY, Guan H, Zhu Y. Clinical sympotoms in 455 hyperparathyroidism patients. Zhongguo Yi Xue Ke Xue Yuan Xue Bao (Chinese), 2011,33(3):330–333

    Google Scholar 

  2. Fraser WD. Hyperparathyroidism. Lancet, 2009,374(9684):145–158

    Article  CAS  PubMed  Google Scholar 

  3. Levy JM, Kandil E, Yau LC, et al. Can ultrasound be used as the primary screening modality for the localization of parathyroid disease prior to surgery for primary hyperparathyroidism? A review of 440 cases. ORL J Otorhinolaryngol Relat Spec, 2011,73(2):116–120

    Article  PubMed  Google Scholar 

  4. Arciero CA, Shiue ZS, Gates JD, et al. Preoperative thyroid ultrasound is indicated in patients undergoing parathyroidectomy for primary hyperparathyroidism. J Cancer, 2012,3:1–6

    Article  PubMed  Google Scholar 

  5. de Feo ML, Colagrande S, Biagini C, et a1. Parathyroid glands: combination of 99mTc-MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology, 2000,214(2):393–402

    Article  PubMed  Google Scholar 

  6. Levine DS, Belzberg AS, Wiseman SM. Hybrid SPECT/CT imaging for primary hyperparathyroidism: case reports and pictorial review. Clin Nucl Med, 2009,34(11):779–784

    Article  PubMed  Google Scholar 

  7. Tailefer R, Boucher Y, Potvin C, et al. Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double phase study). J Nucl Med, 1992,33(10):1801–1807

    Google Scholar 

  8. Hughes DT, Sorensen MJ, Miller BS, et al. The biochemical severity of primary hyperparathyroidism correlates with the localization accuracy of sestamibi and surgeon-performed ultrasound. J Am Coll Surg, 2014,219(5):1010–1019

    Article  PubMed  Google Scholar 

  9. Zhao M, Li X, Huang J, et al. Value of single photon emission computed tomography/computerized tomography in the diagnosis of hyperparathyroidism and the comparative study with multiple imaging modality. Zhong Nan Da Xue Xue Bao Yi Xue Ban (Chinese), 2015,40(9):1016–1022

    Google Scholar 

  10. Caldarella C, Treglia G, Pontecorvi A, et al. Diagnostic performance of planar scintigraphy using 99mTc-MIBI in patients with secondary hyperparathyroidism: a meta-analysis. Ann Nucl Med, 2012,26(10):794–803

    Article  PubMed  Google Scholar 

  11. Zhen L, Li H, Liu X, et al. The application of SPECT/CT for preoperative planning in patients with secondary hyperparathyroidism. Nucl Med Commun, 2013,34(5):439–444

    Article  PubMed  Google Scholar 

  12. Yang J, Hao R, Yuan L, et al. Value of dual-phase (99m)Tc-sestamibi scintigraphy with neck and thoracic SPECT/CT in secondary hyperparathyroidism. AJR Am J Roentgenol, 2014,202(1):180–184

    Article  PubMed  Google Scholar 

  13. Liu H, Jiang YX, Zhang JX, et al. Ultrasonography detection of parathyroid lesion in patients with hyperparathyroidism. Chin J Ultrason (Chinese), 2004,13(8):581–584

    Google Scholar 

  14. Untch BR, Adam MA, Scheri RP, et al. Surgeon-performed ultrasound is superior to 99mTc-sestamibi scanning to localize parathyroid adenomas in patients with primary hyperparathyroidism: results in 516 patients over 10 years. J Am Coll Surg, 2011,212(4):522–529

    Article  PubMed  Google Scholar 

  15. Chandramohan A, Sathyakumar K, Irodi A, et al. Causes of discordant or negative ultrasound of parathyroid glands in treatment naive patients with primary hyperparathyrosdism. Eur J Radiol, 2012,81(12):3956–3964

    Article  PubMed  Google Scholar 

  16. Gao S, Tan J, Xu JH, et al. Value of preoperative imaging localization for primary hyperparathyroidism. Chin J Nucl Med (Chinese), 1998,18(1):38–40

    Google Scholar 

  17. Geatti O, Shapiro B, Orsulom P, et al. Localization of parathyroid enlargement: experience with technetium-99m methoxy-isobutylisonitrile and thallium-201 scintigraphy, ultrasonography and computed tomography. Eur J Nucl Med, 1994,21(1):17–22

    Article  CAS  PubMed  Google Scholar 

  18. Ozkaya M, Elboga U, Sahin E, et al. Evaluation of conventional imaging techniques on preoperative localization in primary hyperparathyroidism. Bosn J Basic Med Sci, 2015,15(1):61–66

    Article  PubMed  PubMed Central  Google Scholar 

  19. Wei B, Shen H, Tong G, et al. Efficiency of (99 m)Tc-sestamibi in diagnosis of parathyroid diseases with primary hyperparathyroidism. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi (Chinese), 2015,50(2):123–126

    Google Scholar 

  20. Calva Cerqueira D, Smith BJ, Hostetler MJ, et al. Minimally invasive parathyroidectomy and preoperative MIBI scans: correlation of gland weight and preoperative PTH. J Am Coll Surg, 2007,205(4 Suppl):S38–S44

    Article  PubMed  Google Scholar 

  21. Palestro CJ, Tomas MB, Tronco GG. Radionuclide imaging of the parathyroid glands. Semin Nucl Med, 2005,35(4):266–276

    Article  PubMed  Google Scholar 

  22. Zhao YY, Wang Q, Li Y, et al. Parathyroid hormone measurement and 99mTc-MIBI imaging for hyperparathyroidism diagnosis. Chin J Nucl Med, 2011,31(4):263–266

    Google Scholar 

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Authors and Affiliations

  1. Department of Nuclear Medicine, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China

    Jun Zhou  (周 俊), Di-yu Lu  (陆涤宇), Liang Xia  (夏 亮) & Xiao-jie Cheng  (程小杰)

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  1. Jun Zhou  (周 俊)
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  2. Di-yu Lu  (陆涤宇)
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  3. Liang Xia  (夏 亮)
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  4. Xiao-jie Cheng  (程小杰)
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Correspondence to Di-yu Lu  (陆涤宇).

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Zhou, J., Lu, Dy., Xia, L. et al. Diagnosis performance of 99mTc-MIBI and multimodality imaging for hyperparathyroidism. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 37, 582–586 (2017). https://doi.org/10.1007/s11596-017-1776-y

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  • DOI: https://doi.org/10.1007/s11596-017-1776-y

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