Diagnostic value of <sup>99</sup>Tc<sup>m</sup>-MIBI dual-time imaging for parathyroid adenoma and parathyroid hyperplasia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yan ¹ , WANG Qi ¹ , YANG Lulu ¹ , LIANG Yiqian ¹ , YANG Aimin ¹ , XU Wei ² ,  XUE Jianjun ¹

1. Department of Nuclear Medicine, The First Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an 710061, P. R. China;
2. Department of Laboratory Division, The First Affiliated Hospital of Xi’an Jiaotong University School of Medicine, Xi’an 710061, P. R. China;

Corresponding author：

XUE Jianjun, Email: xuejianjun@mail.xjtu.edu.cn

Keywords：

hyperparathyroidism; ⁹⁹Tc^m-methoxy isobutyl isonitrile dual-time imaging; parathyroid adenoma; parathyroid hyperplasia; diagnosis

DOI：

10.7507/1007-9424.202101044

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the diagnostic value of ⁹⁹Tc^m-methoxy isobutyl isonitrile (MIBI) dual-time imaging for parathyroid adenoma (PA) and parathyroid hyperplasia (PH).Methods Clinical data of 187 patients with pathologically confirmed hyperparathyroidism (HPT) who admitted to the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine from July 2011 to December 2018 were retrospectively collected. Taking postoperative pathology as the standard, the diagnostic value of preoperative ⁹⁹Tc^m-MIBI dual-time imaging was analyzed.Results The serum PTH level of PH patients was higher than that of PA patients (Z=–3.23, P<0.01). T_e/N (T: focal area radioactive count, N: the normal tissue radioactivity count of the corresponding thyroid gland on the opposite side of the lesion) in PA and PH patients were lower than T_d/N (Z=–3.61, P<0.01; Z=–3.47, P<0.01). The positive rates of ⁹⁹Tc^m-MIBI dual-time imaging in the diagnosis of PA and PH lesions were 67.9% (36/53) and 20.6% (86/418), respectively, and the positive rate of PA were higher (χ²=52.51, P<0.01). The positive rate of ⁹⁹Tc^m-MIBI dual-time imaging in the diagnosis of PA and PH single lesions was higher than that of multiple lesions (χ²=15.79, P<0.01; χ²=64.73, P<0.01). Conclusions ⁹⁹Tc^m-MIBI dual-time imaging shows a higher positive rate for PA and a lower positive rate for PH. When HPT is clinically suspected, but ⁹⁹Tc^m-MIBI dual-time imaging is negative and serum PTH is positive, PH should be considered, and B ultrasound and other examinations should be performed to determine the lesion site.

Citation： LIU Yan, WANG Qi, YANG Lulu, LIANG Yiqian, YANG Aimin, XU Wei, XUE Jianjun. Diagnostic value of ⁹⁹Tc^m-MIBI dual-time imaging for parathyroid adenoma and parathyroid hyperplasia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(11): 1457-1461. doi: 10.7507/1007-9424.202101044 Copy

1.	Diaconescu MR, Costea I, Glod M, et al. Parathyroid adenomas in adults and adolescents. Critical appraisal and surgical strategy in 18 cases. Chirurgia (Bucur), 2017, 112(1): 18-24.
2.	Schillaci G, Pucci G, Pirro M, et al. Large-artery stiffness: a reversible marker of cardiovascular risk in primary hyperparathyroidism. Atherosclerosis, 2011, 218(1): 96-101.
3.	Udelsman R, Åkerström G, Biagini C, et al. The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab, 2014, 99(10): 3595-3606.
4.	Lee JB, Kim WY, Lee YM. The role of preoperative ultrasonography, computed tomography, and sestamibi scintigraphy localization in secondary hyperparathyroidism. Ann Surg Treat Res, 2015, 89(6): 300-305.
5.	Goroshi M, Lila AR, Jadhav SS, et al. Percentage arterial enhancement: An objective index for accurate identification of parathyroid adenoma/hyperplasia in primary hyperpara- thyroidism. Clin Endocrinol (Oxf), 2017, 87(6): 791-798.
6.	邬鹏跃, 张一秋, 石洪成. 放射性核素检查在甲状旁腺腺瘤诊断中的应用. 中国临床医学, 2012, 19(6): 717-718.
7.	李荣红. 原发性甲状旁腺功能亢进症的临床特点分析及治疗观察. 大家健康(中旬版), 2014, 8(9): 131.
8.	Cheung K, Wang TS, Farrokhyar F, et al. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Ann Surg Oncol, 2012, 19(2): 577-583.
9.	卢毅, 程广明, 王理想, 等. 继发性甲状旁腺功能亢进甲状旁腺定位方法研究进展. 中国实用外科杂志, 2018, 38(3): 337-340.
10.	崔铭, 廖泉. 原发性甲状旁腺功能亢进症诊疗模式的转变. 中国普外基础与临床杂志, 2020, 27(10): 1189-1191.
11.	Yip L, Pryma DA, Yim JH, et al. Sestamibi SPECT intensity scoring system in sporadic primary hyperparathyroidism. World J Surg, 2009, 33(3): 426-433.
12.	陈海冰, 吴松华, 寇静鑫, 等. 一例伴染色体易位的多发性内分泌腺肿瘤综合征1型. 中华内分泌代谢杂志, 2012, 28(9): 767-772.
13.	陈辰. ⁹⁹Tc^m-MIBI SPECT/CT 双时相融合断层显像半定量分析对不同组织学分型的甲状旁腺亢进症的诊断价值初探. 广州医科大学, 2016.
14.	唐嘉励, 段东, 张辉. ⁹⁹Tc^m-MIBI SPECT/CT 显像及平面显像半定量分析对原发性甲状旁腺功能亢进症的诊断价值. 中华内分泌外科杂志, 2019, 13(1): 17-21.
15.	史葳, 龚志琰, 李欢欢, 等. 超声及 ⁹⁹Tc^m-MIBI 核素显像对甲状旁腺腺瘤诊断价值的评价. 重庆医科大学学报, 2018, 43(11): 1495-1499.
16.	张峻嘉, 边学海. 甲状旁腺疾病术前定位方法的比较与进展. 中国实验诊断学, 2018, 22(8): 1466-1468.
17.	O’Doherty MJ, Kettle AG, Wells P, et al. Parathyroid imaging with technetium-99m-sestamibi: preoperative localization and tissue uptake studies. J Nucl Med, 1992, 33(3): 313-318.
18.	Taillefer R, Boucher Y, Potvin C, et al. Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study). J Nucl Med, 1992, 33(10): 1801-1807.
19.	李帝, 张琳, 邓大平. ⁹⁹Tc^m-MIBI SPECT/CT 显像在原发性甲状旁腺功能亢进症诊断中的价值讨论. 中国辐射卫生, 2019, 28(2): 194-197.
20.	Thomas DL, Bartel T, Menda Y, et al. Single photon emission computed tomography (SPECT) should be routinely performed for the detection of parathyroid abnormalities utilizing technetium-99m sestamibi parathyroid scintigraphy. Clin Nucl Med, 2009, 34(10): 651-655.
21.	张悦, 张遵城, 李小东, 等. ⁹⁹Tc^m-MIBI 双时相核素显像在原发性甲旁亢术前定位诊断中的应用. 天津医科大学学报, 2010, 16(4): 669-670.
22.	王晨, 赵志刚, 郑瑞芝. 原发性甲状旁腺功能亢进 39 例诊断及治疗分析. 中华实用诊断与治疗杂志, 2015, 29(5): 458-459.
23.	Gupta Y, Ahmed R, Happerfield L, et al. P-glycoprotein expression is associated with sestamibi washout in primary hyperpara- thyroidism. Br J Surg, 2007, 94(12): 1491-1495.
24.	陈正国, 刘启榆, 吴春燕, 等. SPECT/CT 融合显像在继发性甲状旁腺功能亢进症中的临床价值. 中国临床医学影像杂志, 2019, 30(3): 169-173.
25.	Xue J, Liu Y, Ji T, et al. Comparison between technetium-99m methoxyisobutylisonitrile scintigraphy and ultrasound in the diagnosis of parathyroid adenoma and parathyroid hyperplasia. Nucl Med Commun, 2018, 39(12): 1129-1137.
26.	黄盛, 刘晓芳, 谢飞来, 等. 术前立体定位在继发性甲状旁腺功能亢进症手术中的应用. 中国普外基础与临床杂志, 2021, 28(2): 219-223.

1. Diaconescu MR, Costea I, Glod M, et al. Parathyroid adenomas in adults and adolescents. Critical appraisal and surgical strategy in 18 cases. Chirurgia (Bucur), 2017, 112(1): 18-24.
2. Schillaci G, Pucci G, Pirro M, et al. Large-artery stiffness: a reversible marker of cardiovascular risk in primary hyperparathyroidism. Atherosclerosis, 2011, 218(1): 96-101.
3. Udelsman R, Åkerström G, Biagini C, et al. The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab, 2014, 99(10): 3595-3606.
4. Lee JB, Kim WY, Lee YM. The role of preoperative ultrasonography, computed tomography, and sestamibi scintigraphy localization in secondary hyperparathyroidism. Ann Surg Treat Res, 2015, 89(6): 300-305.
5. Goroshi M, Lila AR, Jadhav SS, et al. Percentage arterial enhancement: An objective index for accurate identification of parathyroid adenoma/hyperplasia in primary hyperpara- thyroidism. Clin Endocrinol (Oxf), 2017, 87(6): 791-798.
6. 邬鹏跃, 张一秋, 石洪成. 放射性核素检查在甲状旁腺腺瘤诊断中的应用. 中国临床医学, 2012, 19(6): 717-718.
7. 李荣红. 原发性甲状旁腺功能亢进症的临床特点分析及治疗观察. 大家健康(中旬版), 2014, 8(9): 131.
8. Cheung K, Wang TS, Farrokhyar F, et al. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Ann Surg Oncol, 2012, 19(2): 577-583.
9. 卢毅, 程广明, 王理想, 等. 继发性甲状旁腺功能亢进甲状旁腺定位方法研究进展. 中国实用外科杂志, 2018, 38(3): 337-340.
10. 崔铭, 廖泉. 原发性甲状旁腺功能亢进症诊疗模式的转变. 中国普外基础与临床杂志, 2020, 27(10): 1189-1191.
11. Yip L, Pryma DA, Yim JH, et al. Sestamibi SPECT intensity scoring system in sporadic primary hyperparathyroidism. World J Surg, 2009, 33(3): 426-433.
12. 陈海冰, 吴松华, 寇静鑫, 等. 一例伴染色体易位的多发性内分泌腺肿瘤综合征1型. 中华内分泌代谢杂志, 2012, 28(9): 767-772.
13. 陈辰. ⁹⁹Tc^m-MIBI SPECT/CT 双时相融合断层显像半定量分析对不同组织学分型的甲状旁腺亢进症的诊断价值初探. 广州医科大学, 2016.
14. 唐嘉励, 段东, 张辉. ⁹⁹Tc^m-MIBI SPECT/CT 显像及平面显像半定量分析对原发性甲状旁腺功能亢进症的诊断价值. 中华内分泌外科杂志, 2019, 13(1): 17-21.
15. 史葳, 龚志琰, 李欢欢, 等. 超声及 ⁹⁹Tc^m-MIBI 核素显像对甲状旁腺腺瘤诊断价值的评价. 重庆医科大学学报, 2018, 43(11): 1495-1499.
16. 张峻嘉, 边学海. 甲状旁腺疾病术前定位方法的比较与进展. 中国实验诊断学, 2018, 22(8): 1466-1468.
17. O’Doherty MJ, Kettle AG, Wells P, et al. Parathyroid imaging with technetium-99m-sestamibi: preoperative localization and tissue uptake studies. J Nucl Med, 1992, 33(3): 313-318.
18. Taillefer R, Boucher Y, Potvin C, et al. Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study). J Nucl Med, 1992, 33(10): 1801-1807.
19. 李帝, 张琳, 邓大平. ⁹⁹Tc^m-MIBI SPECT/CT 显像在原发性甲状旁腺功能亢进症诊断中的价值讨论. 中国辐射卫生, 2019, 28(2): 194-197.
20. Thomas DL, Bartel T, Menda Y, et al. Single photon emission computed tomography (SPECT) should be routinely performed for the detection of parathyroid abnormalities utilizing technetium-99m sestamibi parathyroid scintigraphy. Clin Nucl Med, 2009, 34(10): 651-655.
21. 张悦, 张遵城, 李小东, 等. ⁹⁹Tc^m-MIBI 双时相核素显像在原发性甲旁亢术前定位诊断中的应用. 天津医科大学学报, 2010, 16(4): 669-670.
22. 王晨, 赵志刚, 郑瑞芝. 原发性甲状旁腺功能亢进 39 例诊断及治疗分析. 中华实用诊断与治疗杂志, 2015, 29(5): 458-459.
23. Gupta Y, Ahmed R, Happerfield L, et al. P-glycoprotein expression is associated with sestamibi washout in primary hyperpara- thyroidism. Br J Surg, 2007, 94(12): 1491-1495.
24. 陈正国, 刘启榆, 吴春燕, 等. SPECT/CT 融合显像在继发性甲状旁腺功能亢进症中的临床价值. 中国临床医学影像杂志, 2019, 30(3): 169-173.
25. Xue J, Liu Y, Ji T, et al. Comparison between technetium-99m methoxyisobutylisonitrile scintigraphy and ultrasound in the diagnosis of parathyroid adenoma and parathyroid hyperplasia. Nucl Med Commun, 2018, 39(12): 1129-1137.
26. 黄盛, 刘晓芳, 谢飞来, 等. 术前立体定位在继发性甲状旁腺功能亢进症手术中的应用. 中国普外基础与临床杂志, 2021, 28(2): 219-223.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic value of ⁹⁹Tc^m-MIBI dual-time imaging for parathyroid adenoma and parathyroid hyperplasia

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnostic value of 99Tcm-MIBI dual-time imaging for parathyroid adenoma and parathyroid hyperplasia

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content

Diagnostic value of ⁹⁹Tc^m-MIBI dual-time imaging for parathyroid adenoma and parathyroid hyperplasia