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Comparison between single-photon emission computed tomography/computed tomography and ultrasound in preoperative detection of parathyroid adenoma

retrospective review of an institutional experience

Okudan, Bernaa; Seven, Bedrib; Coskun, Nazıma; Albayrak, Aynurc

doi: 10.1097/MNM.0000000000001104
Original Articles
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Objective The aim of this study was to evaluate the accuracy of technetium- 99m-methoxyisobutylisonitrile (99mTc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) and ultrasound in preoperative localization of single parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (pHPT) who would be suitable for minimally invasive parathyroidectomy (MIP).

Methods A retrospective study of 143 consecutive patients with biochemical evidence of hyperparathyroidism who underwent preoperative localization of parathyroid lesions using 99mTc-MIBI SPECT/CT and ultrasound, and proceeded to parathyroid surgery at our institution from January 2013 to January 2018. Of these, 125 had single adenomas and are the subject of this study. The sensitivity, positive predictive value (PPV) and accuracy of the two imaging techniques for the accurately identification and lateralization of PTAs were determined using histopathology as the criterion standard.

Results Of 125 PTAs, the correct identification and lateralization were significantly higher by SPECT/CT than ultrasound. SPECT/CT and ultrasound detected lesions with histopathologically proven PTAs in 116 and 95 patients, respectively. The sensitivity, PPV and accuracy were 92.17, 94.64 and 87.60%, respectively, for SPECT/CT and 75.89, 90.43 and 70.25%, respectively, for ultrasound in lateralization analysis.

Conclusions The results of our study indicate that 99mTc-MIBI SPECT/CT is more accurate than ultrasound for the preoperative identification of single PTAs in patients with pHPT who are candidates for MIP.

aDepartment of Nuclear Medicine, Ankara Numune Training and Research Hospital, University of Health Sciences, Ankara

bDepartment of Nuclear Medicine, Sabuncuoğlu Şerefeddin Training and Research Hospital, University of Amasya, Amasya

cDepartment of Pathology, Ankara Numune Training and Research Hospital, University of Health Sciences, Ankara, Turkey

Received 11 July 2019 Accepted 22 September 2019

Correspondence to Bedri Seven, MD, Department of Nuclear Medicine, Sabuncuoğlu Şerefeddin Training and Research Hospital, University of Amasya, 05200 Amasya, Turkey, Tel: +90 358 218 40 00; fax: +90 358 212 00 01; e-mail: bedriseven@yahoo.com

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