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A comparison between 11C-methionine PET/CT and MIBI SPECT/CT for localization of parathyroid adenomas/hyperplasia

Hayakawa, Nobuyukia; Nakamoto, Yujia; Kurihara, Kensukea; Yasoda, Akihirob; Kanamoto, Naotetsub,d; Miura, Masakob,c; Inagaki, Nobuyab; Togashi, Kaoria

Nuclear Medicine Communications: January 2015 - Volume 36 - Issue 1 - p 53–59
doi: 10.1097/MNM.0000000000000216

Objective The purpose of this study was to compare the sensitivity of single-photon emission computed tomography/computed tomography (SPECT/CT) using 99mTc-sestamibi (MIBI) with that of PET/CT using 11C-methionine (MET) for localization of parathyroid adenomas/hyperplasia in primary hyperparathyroidism.

Materials and methods Twenty-three patients with primary hyperparathyroidism were analyzed. Fifteen patients underwent surgery, and the remaining eight did not, but these patients were clinically diagnosed as having primary hyperparathyroidism. Patients underwent both MET PET/CT and MIBI SPECT/CT scanning. The sensitivities of both modalities were evaluated on a per-patient basis, and on a per-lesion basis for parathyroid lesions detected by surgery. The size of the parathyroid adenoma/hyperplasia and serum intact parathyroid hormone levels were compared with the results of each of the two modalities.

Results Per-patient sensitivities of MET PET/CT and MIBI SPECT/CT were 65 and 61%, respectively. Per-lesion sensitivities of MET PET/CT and MIBI SPECT/CT were 91 and 73% for histologically confirmed adenomas and 30 and 30% for hyperplastic glands, respectively. No significant differences were observed between the two modalities. The size of uptake-positive lesions was significantly larger than that of uptake-negative lesions in both modalities. Intact parathyroid hormone levels showed no significant difference between uptake-positive and uptake-negative patients in both modalities.

Conclusion The sensitivities of MET PET/CT and MIBI SPECT/CT were comparable. MET PET/CT has a complementary role in localizing parathyroid adenomas/hyperplasia when MIBI SPECT/CT is inconclusive.

Departments of aDiagnostic Imaging and Nuclear Medicine

bDiabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine

cDepartment of Endocrinology, Rakuwakai Otowa Hospital, Kyoto

dDepartment of Endocrinology, Osaka City General Hospital, Osaka, Japan

Data were presented previously at the Society of Nuclear Medicine and Molecular Imaging’s (SNMMI) annual meeting and published as an abstract in J Nucl Med 2013; 54 (Supplement 2):142.

Correspondence to Yuji Nakamoto, MD, PhD, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-Ku, Kyoto 606-8507, Japan Tel: +81 75 751 3761; fax: +81 75 771 9709; e-mail:

Received July 14, 2014

Received in revised form August 23, 2014

Accepted August 25, 2014

© 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins