Value of 99mTc-MIBI SPECT/CT parathyroid imaging and ultrasonography for concomitant thyroid carcinoma.

Abstract

PURPOSE:

We aimed to assess the frequency of carcinoma in cases with suspected parathyroid adenoma and test the value of Tc-methoxyisobutylisonitrile (Tc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) parathyroid imaging and neck ultrasonography in detecting concomitant thyroid carcinoma.

PATIENTS AND METHODS:

We enrolled 741 patients with clinically suspected parathyroid adenoma who underwent Tc-MIBI planer scans and SPECT/CT of the skull base, neck, and thorax; patients also underwent ultrasonography within 1 month before SPECT/CT. Each case with suspected lesion was analyzed and correlated with pathology. We estimated the frequency of carcinoma detection on SPECT/CT performed for suspected parathyroid adenoma. The sensitivity, specificity, and accuracy of detecting thyroid carcinoma were estimated for both SPECT/CT and ultrasonography.

RESULTS:

In total, 222 patients with 250 pathology results were assessed. Of these, 54 patients showed carcinoma. With respect to the anatomical distribution of the incidental findings, 19 (35.19%) had parathyroid carcinoma, 20 (37.04%) had papillary thyroid carcinoma, three (5.56%) had follicular thyroid carcinoma, six (11.11%) had medullary thyroid carcinoma, and six (11.11%) had other carcinomas. For thyroid carcinoma detection, the sensitivity, specificity, and accuracy were 35.71, 88.16, and 80.49% for SPECT/CT and 73.81, 95.10, and 91.99% for ultrasonography, respectively.

CONCLUSION:

The frequency of carcinoma is high on Tc-MIBI SPECT/CT performed for suspected parathyroid adenoma. Although Tc-MIBI SPECT/CT plays an important role in the diagnosis and location of parathyroid adenoma, ultrasonography appears to be more suitable for identifying a concomitant thyroid carcinoma. This may vitally influence the choice of therapeutic regimen in patients with primary hyperparathyroidism.

• Authors: Rui Guo, Jiqiu Wang, Min Zhang, Miao Zhang, Hongping Meng, Yifan Zhang, Biao Li
• Journal: Nuclear medicine communications (Nucl Med Commun) Vol. 38 Issue 8 Pg. 676-682 (Aug 2017) ISSN: 1473-5628 [Electronic] England
• PMID: 28614134 (Publication Type: Journal Article)

Chemical References

• Technetium Tc 99m Sestamibi

Topics

• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Neck (diagnostic imaging)
• Parathyroid Glands (diagnostic imaging)
• Retrospective Studies
• Single Photon Emission Computed Tomography Computed Tomography
• Technetium Tc 99m Sestamibi
• Thyroid Neoplasms (diagnostic imaging)
• Ultrasonography
• Young Adult