| Objective: To investigate the diagnostic value of semi-quantitative analysis of 99mTc-MIBI thyroid imaging and ROC curve in distinguishing cold nodule. Methods: 73 patients with cold nodule underwent 99mTcO4- and 99mTc-MIBI scintigraphy. 99mTc-MIBI imaging was undertaken at 15 min(early) and 120 min(delayed) after injection. Semi-quantitative analysis was performed using the early ratio(ER) and delayed ratio(DR) Of tumor /non-lesion. DR(0.8) Of tumor /non-lesion(T/N) was consider as threshold. Counting the ratio of tumor/submaxillary gland (T/S) and tumor/heart (T/H) .The respective thresholds were obtained from ROC, All patients were verified by surgery. Results: Thyroid surgery and pathology proved 8 malignant and 60 benign lesions. The sensitivity, specificity and accuracy of MIBI semi-quantitative analysis was 90%, 77.8% and 79.4% respectively. The threshold (T/N=0.995,T/S= .995,T/H=0.810) were gained from ROC curve of DR and was used to distinguish cold nodule. The sensitivity was 90%, 80%, 80% respectively, the specificity was 90.5%,87.3%,79.4%. The area under the ROC curve of delayed was 0.908,0.845, 0.840 respectively, These were more than A of ER respectively. There was statistical difference (P< 0.05) between 0.8 and 0.995. Conclusion: ROC curve can enhance the diagnosis ability of 99mTc-MIBI thyroid imaging. DR is more valuable than ER, DR(0.995) of T/N is the best parameter, DR of T/S and T/N are helpful in the diagnosis.
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