COMPARATIVE STUDY
JOURNAL ARTICLE
RESEARCH SUPPORT, NON-U.S. GOV'T
Add like
Add dislike
Add to saved papers

Diagnostic performance of ultrasonography, dual-phase 99m Tc-MIBI scintigraphy, early and delayed 99m Tc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism.

BMC Medical Imaging 2020 August 4
BACKGROUND: Secondary hyperparathyroidism (SHPT) usually requires parathyroidectomy when drug regimens fail. However, obtaining an exact preoperative map of the locations of the parathyroid glands is a challenge. The purpose of this study was to compare the diagnostic performance of US, dual-phase 99m Tc-MIBI scintigraphy, early and delayed 99m Tc-MIBI SPECT/CT in patients with SHPT.

METHODS: Sixty patients with SHPT who were undergoing dialysis were evaluated preoperatively by US, dual-phase 99m Tc-MIBI scintigraphy, early and delayed 99m Tc-MIBI SPECT/CT. Postoperative pathology served as the gold standard. The sensitivity, specificity, and accuracy were determined for each method. Spearman correlation analysis was used to analyse the correlation of hyperplastic parathyroid calcification with serum alkaline phosphatase (ALP) and parathyroid hormone (PTH).

RESULTS: A total of 229 lesions in 60 patients were pathologically confirmed to be parathyroid hyperplasia, with 209 lesions in typical sites, 15 lesions in the upper mediastinum and 5 lesions in the thyroid. A total of 88.33% (53/60) of patients had four lesions. US, early and delayed 99m Tc-MIBI SPECT/CT had significantly higher sensitivity and accuracy than dual-phase 99m Tc-MIBI scintigraphy (P < 0.001). Furthermore, early 99m Tc-MIBI SPECT/CT had significantly higher sensitivity (P < 0.001) and accuracy (P = 0.001 and P < 0.001) than US and delayed 99m Tc-MIBI SPECT/CT. In patients with ectopic hyperplastic parathyroid glands, the sensitivity of early 99m Tc-MIBI SPECT/CT (90%) was significantly higher than that of US (55%) and dual-phase 99m Tc-MIBI scintigraphy (50%) (P < 0.05). The Spearman correlation results showed a significant albeit weak association between calcification and both serum PTH and ALP (P = 0.002).

CONCLUSION: The ability of early 99m Tc-MIBI SPECT/CT to detect hyperplastic parathyroid glands in patients with SHPT is superior to that of US, dual-phase 99m Tc-MIBI scintigraphy and delayed 99m Tc-MIBI SPECT/CT; furthermore, dual-phase 99m Tc-MIBI SPECT/CT is not essential.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app