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Diagnostic performance of planar scintigraphy using 99mTc-MIBI in patients with secondary hyperparathyroidism: a meta-analysis

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Abstract

Objective

Parathyroid scintigraphy using 99mTc-MIBI is not currently considered a valuable diagnostic tool for the localization of involved glands in patients with secondary hyperparathyroidism (SHPT). However, published data about its diagnostic accuracy are discordant and a meta-analysis about this topic is still lacking. The aim of our study is to meta-analyze the published data about the diagnostic performance of 99mTc-MIBI parathyroid scintigraphy in patients with SHPT.

Methods

A comprehensive computer literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through September 2011 and regarding the diagnostic accuracy of 99mTc-MIBI parathyroid scintigraphy in patients with SHPT was carried out. Only articles in English language in which at least 10 patients with SHPT underwent planar 99mTc-MIBI parathyroid scintigraphy were selected. Pooled sensitivity, pooled specificity and area under the ROC curve on a per lesion-based analysis were calculated to measure the diagnostic accuracy of 99mTc-MIBI parathyroid scintigraphy in SHPT patients.

Results

Twenty-four studies comprising 471 patients were included in this meta-analysis. The pooled sensitivity and specificity of 99mTc-MIBI parathyroid scintigraphy in detecting hyperplastic glands in SHPT patients were 58 % [95 % confidence interval (95 % CI) 52–65 %] and 93 % (95 % CI 85–100 %), respectively, on a per lesion-based analysis. Area under ROC curve was 0.75.

Conclusions

In patients with SHPT and diffuse or nodular hyperplasia, planar parathyroid scintigraphy using 99mTc-MIBI has demonstrated an inadequate diagnostic accuracy. Therefore, it should not be considered as a first-line diagnostic imaging method in the pre-surgical detection of hyperplastic parathyroid glands.

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Authors and Affiliations

  1. Department of Bioimaging and Radiological Sciences, Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168, Rome, Italy

    Carmelo Caldarella, Giorgio Treglia & Alessandro Giordano

  2. Department of Internal Medicine, Institute of Endocrinology, Catholic University of the Sacred Heart, Rome, Italy

    Alfredo Pontecorvi

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  1. Carmelo Caldarella
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  2. Giorgio Treglia
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Correspondence to Carmelo Caldarella.

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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 26, 794–803 (2012). https://doi.org/10.1007/s12149-012-0643-y

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