Diagnostic Values Of ^99mTc-MIBI Imaging Combined With SPECT/CT And Semiquantitative Analysis In PHPT

ObjectiveThis study aimed to evaluate the diagnostic value of ^99mTc-MIBI SPECT/CT imaging and ^99mTc-MIBI planar imaging semi-quantitative analysis in primary hyperparathyroidism?PHPT?.Materials and MethodsA total of 89 patients were enrolled into this retrospective study.The diagnostic efficiencies of ^99mTc-MIBI SPECT/CT were compared with^99mTc-MIBI planar scintigraphy and ultrasound,while the surgical pathology and the clinical follow-up results were considered as the standard.The region of interest extraction technique was used to measure and calculate the target to normal tissue ratios?T/NT?in the early and delayed phase of the planar scintigraphy,then the ROC curves of T/NT were drawn respectively,by which the best decisive threshold was obtained.Eventually,the correlation between pathological type,PTH concentration and T/NT ratios were analysed.Results1)The sensitivities and specificities of SPECT/CT,^99mTc-MIBI planar scintigraphy and ultrasound were 98.08%,88.46%,78.43%and82.93%,82.93%,58.82%respectively.The sensitivity and specificity of SPECT/CT were significantly higher than that of ultrasound respectively?both P<0.05?,but similar to that of individual planar imaging?both P>0.05?.2)The area under the delayed phase T/NT ratio curve was the biggest one,of which the best decisive threshold was 1.59 with the sensitivity of89.2%and the specificity of 87.0%.3)There were statistically significant correlations between the pathological type and PTH concentration,early phase T/NT and delayed phase T/NT respectively.Conclusion^99mTc-MIBI SPECT/CT imaging is an effective method for diagnosis of PHPT,with higher clinical application value than ^99mTc-MIBI planar scintigraphy and ultrasound.The semi-quantitative analysis of ^99mTc-MIBI planar scintigraphy provides a new method for the differential diagnosis of PHPT.