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Efficacy of 99mTc-sestamibi SPECT/CT for minimally invasive parathyroidectomy: comparative study with 99mTc-sestamibi scintigraphy, SPECT, US and CT

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Abstract

Purpose

We evaluated the efficacy of 99mTc-sestamibi SPECT/CT for planning minimally invasive parathyroidectomy (MIP), comparing with dual phase 99mTc-sestamibi scintigraphy, 99mTc-sestamibi SPECT and conventional imaging (US and CT).

Methods

Thirty-one patients (M:F = 10:21, range 35–78 years old) who showed high serum parathyroid hormone (intact PTH) level were included. 99mTc-sestamibi scintigraphy was performed 15 and 150 min after injection of 99mTc-sestamibi (555 MBq), and 99mTc-sestamibi SPECT/CT was obtained just after the delayed scan. Comparison study between imaging modalities was done by patient-based and lesion location-based analysis. The location of the lesion was confirmed by the operative finding. An operation was performed in 24 patients. Seven patients had normal 99mTc-sestamibi SPECT/CT, and followed for more than 6 months after SPECT/CT.

Results

Among 24 patients, parathyroid adenoma was detected in 19 patients and the other 5 had parathyroid hyperplasia (total 35 lesions). 99mTc-sestamibi scintigraphy detected abnormal uptake in 15 patients with 24 lesions. Conventional imaging identified abnormal findings in 17 patients with 27 lesions. SPECT detected abnormal findings in 18 patients with 27 lesions. SPECT/CT identified abnormal findings in 24 patients with 35 lesions. SPECT/CT demonstrated 100 % sensitivity in a patient-based analysis. SPECT/CT exhibited significantly better sensitivity than 99mTc-sestamibi scintigraphy, SPECT and conventional imaging (p < 0.05). All lesion location was correctly identified to perform MIP. The final clinical diagnosis of 7 normal SPECT/CT patients was secondary hyperparathyroidism on 6 months follow-up.

Conclusions

We correctly identified the precise location of parathyroid adenomas or hyperplasia by 99mTc-sestamibi SPECT/CT which was helpful to perform MIP.

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Conflict of interest

No potential conflicts of interest were disclosed.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea

    Yong-il Kim & Ho-Young Lee

  2. Department of Otolaryngology, Seoul National University Hospital Boramae Medical Center, Seoul, Korea

    Young Ho Jung

  3. Department of Surgery, Seoul National University Hospital Boramae Medical Center, Seoul, Korea

    Ki Tae Hwang

  4. Cancer Research Institute, Seoul National University, Seoul, Korea

    Ho-Young Lee

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  1. Yong-il Kim
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  2. Young Ho Jung
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Correspondence to Ho-Young Lee.

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Kim, Yi., Jung, Y.H., Hwang, K.T. et al. Efficacy of 99mTc-sestamibi SPECT/CT for minimally invasive parathyroidectomy: comparative study with 99mTc-sestamibi scintigraphy, SPECT, US and CT. Ann Nucl Med 26, 804–810 (2012). https://doi.org/10.1007/s12149-012-0641-0

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  • DOI: https://doi.org/10.1007/s12149-012-0641-0

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