Volume 14 Issue 4
Jul.  2023
Turn off MathJax
Article Contents
LIU Yimin, CHEN Libo, LIU Yu, WANG Zhenghua, HU Nan, LI Congxin, ZHU Shikun, ZHANG Zheng, JING Hongli, HUO Li. Clinical Values of 99mTc-MIBI Pinhole Dual-phase and Parallel-hole SPECT/CT for Preoperative Localization in Patients with Primary Hyperparathyroidism[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 774-780. doi: 10.12290/xhyxzz.2023-0164
Citation: LIU Yimin, CHEN Libo, LIU Yu, WANG Zhenghua, HU Nan, LI Congxin, ZHU Shikun, ZHANG Zheng, JING Hongli, HUO Li. Clinical Values of 99mTc-MIBI Pinhole Dual-phase and Parallel-hole SPECT/CT for Preoperative Localization in Patients with Primary Hyperparathyroidism[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 774-780. doi: 10.12290/xhyxzz.2023-0164

Clinical Values of 99mTc-MIBI Pinhole Dual-phase and Parallel-hole SPECT/CT for Preoperative Localization in Patients with Primary Hyperparathyroidism

doi: 10.12290/xhyxzz.2023-0164
Funds:

National Key Research and Development Program of China 2020YFC2002702

More Information
  • Corresponding author: CHEN Libo, E-mail: ellenmi@sina.cn
  • Received Date: 2023-03-30
  • Accepted Date: 2023-05-06
  • Publish Date: 2023-07-30
  •   Objective  To evaluate the clinical values of preoperative 99mTc-methoxyisobutylisonitrile (MIBI) pinhole collimator duplex imaging versus parallel-hole collimator single photon emission computed tomography (SPECT)/CT tomography fusion imaging in the preoperative localization of primary hyperparathyroidism (PHPT).  Methods  In this diagnostic test, the patients with suspected PHPT in Peking Union Medical College Hospital from July 2021 to February 2022 were retrospectively analyzed. With postoperative histopathology as the gold standard, the sensitivity, accuracy, and positive predictive value of 99mTc-MIBI pinhole collimator duplex imaging and parallel-hole collimator SPECT/CT tomographic fusion imaging for the detection of PHPT lesions were calculated, and the effect of parathyroid hormone (PTH) on the detection of PHPT lesions by these two diagnostic methods was analyzed.  Results  A total of 135 patients with suspected PHPT on 99mTc-MIBI parathyroid imaging were enrolled. A total of 149 lesions were detected on 99mTc-MIBI pinhole collimator diachronic imaging (including 1 ectopic lesion) and 148 lesions were detected on parallel-hole collimator SPECT/CT tomographic fusion imaging (including 11 ectopic lesions; 1 true positive lesion was a fusion of 2 lesions that could not be distinguished by this method). The sensitivity (79.9% vs. 74.8%, P=0.326), accuracy (79.2% vs. 75.7%, P=0.490) and positive predictive value (98.3% vs. 100%, P=0.499) of the two methods for detecting PHPT lesions were not significantly different. In the subgroups with PTH≤150 ng/L and PTH>150 ng/L, the sensitivity (79.1% vs. 80.5%, P=0.838), accuracy (77.5% vs. 80.8%, P=0.688), and positive predictive value (96.4% vs. 100%, P=0.219) of 99mTc-MIBI pinhole collimator diachronic imaging in detecting PHPT lesions were not significantly different; the sensitivity (71.6% vs. 77.6%, P=0.445), accuracy (73.2% vs. 77.9%, P=0.567), and positive predictive value (100% vs. 100%, P> 0.999) of SPECT/CT fusion imaging were also not significantly different.  Conclusions  Both 99mTc-MIBI pinhole collimator parathyroid duplex imaging and parallel-hole collimator SPECT/CT tomographic fusion imaging have good diagnostic ability for PHPT and are not significantly affected by changes in PTH levels. Due to the high resolution of 99mTc-MIBI pinhole collimator parathyroid duplex imaging, it is still an important basis for preoperative localization and diagnosis of PHPT, while parallel-hole collimator SPECT/CT tomographic fusion imaging has obvious advantages for the diagnosis of ectopic PHPT and is recommended in some special cases.
  • loading
  • [1] 夏维波, 邢小平. 《原发性甲状旁腺功能亢进症诊疗指南》解读[J]. 中华骨质疏松和骨矿盐疾病杂志, 2014, 7: 185-186. https://www.cnki.com.cn/Article/CJFDTOTAL-GUSS201403001.htm
    [2] 张翔, 胡亚, 王梦一, 等. 原发性甲状旁腺功能亢进症的术前诊断与外科治疗策略[J]. 中国内分泌外科杂志, 2018, 12: 274-277.
    [3] 张莹莹, 韩娜, 武玉凤, 等. 99Tcm-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症术前诊断中的价值及影响因素[J]. 中国医学影像学杂志, 2021, 41: 345-349. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201516020.htm
    [4] 唐嘉励, 段东, 张辉. 99Tcm-MIBI SPECT/CT显像及平面显像半定量分析对原发性甲状旁腺功能亢进症的诊断价值[J]. 中国内分泌外科杂志, 2019, 13: 17-21. https://www.cnki.com.cn/Article/CJFDTOTAL-DYJD202110019.htm
    [5] 吴书婷, 朱小华, 张国鹏, 等. 甲状旁腺99Tcm-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症术前诊断中的增益价值[J]. 中华核医学与分子影像杂志, 2016, 36: 436-440. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYD202206023.htm
    [6] 钟箫, 欧晓红, 李林, 等. 99TcmMIBI SPECT/CT融合显像在甲状旁腺功能亢进术前诊断中的应用价值[J]. 中华核医学分子影像杂志, 2017, 37: 395-399. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYD202206023.htm
    [7] Maria BT, Paul VP, Gene GT, et al. Pinhole Versus Parallel-Hole Collimators for Parathyriod Imaging: An Intraindividual Comparison[J]. J Nucl Med Technol, 2008, 36: 189-194. doi:  10.2967/jnmt.108.055640
    [8] Biertho LD, Kim C, Wu HS, et al. Relationship between sestamibi uptake, parathyriod hormone assay, and nuclear morphology in primary hyperparathyroidism[J]. J Am CollSurg, 2004, 199: 229-233.
    [9] Calva-Cerqueira D, Smith BJ, Hostefler ML, et al. Minimal invasive parathyroidectomy and preoperative MIBI scan: correlation of gland weight and preoperative PTH[J]. J Am Coll Surg, 2007, 205: S38-S44.
    [10] 周建立, 王健, 朱富强. 甲状旁腺功能亢进症患者血清PTH水平与99mTc-MIBI SPECT/CT双时相显像的相关性研究[J]. 中国临床医学影像杂志, 2020, 31: 171-174. https://www.cnki.com.cn/Article/CJFDTOTAL-LYYX202003009.htm
    [11] Cordes M, Dworak O, Papadopoulos T, et al. MIBI scintigr-aphy of parathyroid adenomas: correlation with biochemical and histological markers[J]. J Endocr Res, 2018, 43: 141-148. doi:  10.1080/07435800.2018.1437747
    [12] Hindié E, Zanotti-Fregonara P, Tabarin A, et al. The role of radionuclide imaging in the surgical management of primary hyperparathyroidism[J]. J Nucl Med, 2015, 56: 737-744. doi:  10.2967/jnumed.115.156018
    [13] Treglia G, Sadeghi R, Schalin-Jäntti C, etal. Detection rate of (99m) Tc-MIBI single photon emission computed tomography (SPECT)/CT in preoperative planning for patients with primary hyperparathyroidism: A meta-analysis[J]. Head Neck, 2016, 38: E2159-E2172. doi:  10.1002/hed.24027
    [14] Lavely WC, Goetzel S, Friedman KP, et al. Comparison of SPECT/CT, SPECT, and Planar Imaging with Single- and Dual-Phase 99mTc-Sestamibi Parathyroid Scintigraphy[J]. J Nucl Med, 2007, 48: 1084-1089.
    [15] Mohammad AG, Abdelhamid HE, Mohammad ME, et al. Comparison of pinhole and high-resolution parallel-hole imaging for nodular thyroid disease[J]. Clin Nucl Med, 2011, 36: 770-771.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(1)

    Article Metrics

    Article views (1563) PDF downloads(27) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return