Value of 99mTc-MIBI SPECT/CT combined with CT imaging features in the diagnosis of primary parathyroid diseases
ZHAO Yujia
BAI Xia
Abstract：Objective To investigate the clinical value of SPECT/CT and CT imaging features in primary hyperparathyroidism(PHPT)with inaccurate imaging location.Methods A total of 90 patients with PHPT confirmed by surgery and pathology were selected and divided into a missed diagnosis group(n=12)and a correct diagnosis group(n=78)according to pathological results,and a parathyroid lesion group(n=81)and a thyroid lesion group(n=29)according to pathological results.The same size areas of interest were delineated in the focal areas of parathyroid,thyroid and contralateral normal areas of parathyroid lesions on the SPECT/CT fusion images,and the radioactive counts of these different sites were recorded,and target-to-non-target ratio(T/NT)and target-to-non-target ratio(TBR)were calculated.The mean values of maximum CT density(CTmax),minimum CT density(CTmin)and mean CT density(CTavg)were collected at three consecutive layers.The data of each group were compared between groups,the working curve of subjects was drawn,and the diagnostic efficacy of each data was evaluated.Results On 99mTc-MIBI SPECT/CT images,the T/NT,TBR,volume,and diameter of the lesions in the missed group were smaller than those in the correctly diagnosed group,and the difference in T/NT between the two groups was statistically significant(P=0.002)and the diagnostic efficiency was the best,while there was no significant difference in TBR,volume,and diameter between the two groups(P>0.05).There was no significant difference in blood Ca and blood P between the parathyroid lesion group and the thyroid lesion group(P>0.05).The parathyroid hormone,TBR,CTmax,CTmin and CTavg in the thyroid lesion group were all lower than those in the parathyroid lesion group(P<0.05).The diagnostic efficiency of CTmax was the best,with AUC of 0.623,sensitivity of 74.10%and specificity of 62.50%.Conclusion SPECT/CT has better diagnostic efficacy than TBR in preoperative localization of PHPT,which can provide more valuable reference for preoperative localization of PHPT.It has good clinical value to treat TBR and CTmax with thyroid lesions.
Keywords：primary hyperparathyroidismSPECT/CTthyroid disease
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 957-963 )