Abstract:

Objective To investigate the value of 99mTc-sestamibi (99mTc-MIBI) and single photon emission computed tomography/computerized tomography (SPECT/CT) in diagnosis of primary hyperparathyroidism (PHPT). Methods Thirty-seven patients with PHPT were selected. Thirty minutes (early phase) and two hours (delayed phase) after intravenous administration of 99mTc-MIBI (740 MBq), dual-phase planar imaging over the neck and chest was performed, followed by SPECT/CT imaging. The imaging findings were compared to the pathological results. Statistical analysis was conducted on the basis of clinical manifestations and laboratory findings with McNemar test. Results In total, 41 parathyroid lesions from 37 patients with PHPT were confirmed by pathology. Among the 37 patients, 29 patients had single parathyroid adenoma (ectopic parathyroid adenoma in 5 patients), 5 patients had single parathyroid hyperplasia lesion, 2 patients had 2 parathyroid adenomas, and the other patient had 3 parathyroid hyperplasia lesions. 99mTc-MIBI SPECT/CT identified 87.8% of the PHPT lesions, with significantly higher diagnostic sensitivity than that of 99mTc-MIBI dual-phase planar imaging (75.6%)（P<0.05）. The sensitivity of 99mTc-MIBI SPECT/CT in diagnosis of parathyroid hyperplasia lesions was 50.0%, while no parathyroid hyperplasia lesion was detected by planar imaging （P<0.05）. SPECT/CT also provided exact anatomical locations of the lesions, which was especially helpful for the surgical treatment of ectopic PHPT lesions. Conclusion 99mTc-MIBI SPECT/CT is more effective than conventional 99mTc-MIBI dual-phase planar imaging in diagnosis of PHPT.

Key words: primary hyperparathyroidism, technetium (99mTc) sestamibi, single photon emission computed omography/computerized tomography, parathyroid imaging