Value of single photon emission computed tomography/computerized tomography in the diagnosis of hyperparathyroidism and the comparative study with multiple imaging modality

Abstract

To compare the diagnostic value among the single photon emission computed tomography/computerized tomography (SPECT/CT), (99m)Tc-sestamibi (MIBI) planar scintigraphy, ultrasonography (US) and computerized tomography (CT) in diagnosis of patients with hyperparathyroidism (HPT). A total of 59 patients were retrospectively recruited for this study. The patients received parathyroidectomy and were verified by pathological examination. Among them, 31, 28 and 26 patients received SPECT/CT, (99m)Tc-MIBI planar scintigraphy, US and CT, respectively, before the parathyroidectomy. The sensitivity for localization or qualitation was compared between SPECT/CT and (99m)Tc-MIBI planar scintigraphy; the sensitivity, specificity and accuracy were compared among the SPECT/CT, (99m)Tc-MIBI planar scintigraphy, US and CT. There was no statistical difference in the sensitivity of localization between SPECT/CT and (99m)Tc-MIBI planar scintigraphy (P>0.05); however, the SPECT/CT exhibited more sensitive than the (99m)Tc-MIBI planar scintigraphy in detection of hyperplastic lesions (P<0.05). Among the four imaging modalities, SPECT/CT had advantages over (99m)Tc-MIBI planar scintigraphy in terms of accuracy (P<0.05). In contrast, the sensitivity of CT was not as good as that of SPECT/CT and US (both P<0.05). For the diagnosis of lesions with a diameter more than 1 cm, the sensitivity of SPECT/CT was the best (all P<0.05). However, the sensitivity of US was the best in diagnosis of lesions with a diameter less than 1 cm (all P<0.05). The SPECT/CT is more effective than (99m)Tc-MIBI planar scintigraphy in diagnosis of HPT, especially in diagnosis of hyperplastic lesions. Both of SPECT/CT and US are recommended to localize the target parathyroid lesions of HPT before the parathyroidectomy.