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

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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, ?kerstr?m 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.	鄔鵬躍, 張一秋, 石洪成. 放射性核素檢查在甲狀旁腺腺瘤診斷中的應用. 中國臨床醫學, 2012, 19(6): 717-718.
7.	李榮紅. 原發性甲狀旁腺功能亢進癥的臨床特點分析及治療觀察. 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.	盧毅, 程廣明, 王理想, 等. 繼發性甲狀旁腺功能亢進甲狀旁腺定位方法研究進展. 中國實用外科雜志, 2018, 38(3): 337-340.
10.	崔銘, 廖泉. 原發性甲狀旁腺功能亢進癥診療模式的轉變. 中國普外基礎與臨床雜志, 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.	陳海冰, 吳松華, 寇靜鑫, 等. 一例伴染色體易位的多發性內分泌腺腫瘤綜合征1型. 中華內分泌代謝雜志, 2012, 28(9): 767-772.
13.	陳辰. ⁹⁹Tc^m-MIBI SPECT/CT 雙時相融合斷層顯像半定量分析對不同組織學分型的甲狀旁腺亢進癥的診斷價值初探. 廣州醫科大學, 2016.
14.	唐嘉勵, 段東, 張輝. ⁹⁹Tc^m-MIBI SPECT/CT 顯像及平面顯像半定量分析對原發性甲狀旁腺功能亢進癥的診斷價值. 中華內分泌外科雜志, 2019, 13(1): 17-21.
15.	史葳, 龔志琰, 李歡歡, 等. 超聲及 ⁹⁹Tc^m-MIBI 核素顯像對甲狀旁腺腺瘤診斷價值的評價. 重慶醫科大學學報, 2018, 43(11): 1495-1499.
16.	張峻嘉, 邊學海. 甲狀旁腺疾病術前定位方法的比較與進展. 中國實驗診斷學, 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, 張琳, 鄧大平. ⁹⁹Tc^m-MIBI SPECT/CT 顯像在原發性甲狀旁腺功能亢進癥診斷中的價值討論. 中國輻射衛生, 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.	張悅, 張遵城, 李小東, 等. ⁹⁹Tc^m-MIBI 雙時相核素顯像在原發性甲旁亢術前定位診斷中的應用. 天津醫科大學學報, 2010, 16(4): 669-670.
22.	王晨, 趙志剛, 鄭瑞芝. 原發性甲狀旁腺功能亢進 39 例診斷及治療分析. 中華實用診斷與治療雜志, 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.	陳正國, 劉啟榆, 吳春燕, 等. SPECT/CT 融合顯像在繼發性甲狀旁腺功能亢進癥中的臨床價值. 中國臨床醫學影像雜志, 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.	黃盛, 劉曉芳, 謝飛來, 等. 術前立體定位在繼發性甲狀旁腺功能亢進癥手術中的應用. 中國普外基礎與臨床雜志, 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, ?kerstr?m 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. 鄔鵬躍, 張一秋, 石洪成. 放射性核素檢查在甲狀旁腺腺瘤診斷中的應用. 中國臨床醫學, 2012, 19(6): 717-718.
7. 李榮紅. 原發性甲狀旁腺功能亢進癥的臨床特點分析及治療觀察. 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. 盧毅, 程廣明, 王理想, 等. 繼發性甲狀旁腺功能亢進甲狀旁腺定位方法研究進展. 中國實用外科雜志, 2018, 38(3): 337-340.
10. 崔銘, 廖泉. 原發性甲狀旁腺功能亢進癥診療模式的轉變. 中國普外基礎與臨床雜志, 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. 陳海冰, 吳松華, 寇靜鑫, 等. 一例伴染色體易位的多發性內分泌腺腫瘤綜合征1型. 中華內分泌代謝雜志, 2012, 28(9): 767-772.
13. 陳辰. ⁹⁹Tc^m-MIBI SPECT/CT 雙時相融合斷層顯像半定量分析對不同組織學分型的甲狀旁腺亢進癥的診斷價值初探. 廣州醫科大學, 2016.
14. 唐嘉勵, 段東, 張輝. ⁹⁹Tc^m-MIBI SPECT/CT 顯像及平面顯像半定量分析對原發性甲狀旁腺功能亢進癥的診斷價值. 中華內分泌外科雜志, 2019, 13(1): 17-21.
15. 史葳, 龔志琰, 李歡歡, 等. 超聲及 ⁹⁹Tc^m-MIBI 核素顯像對甲狀旁腺腺瘤診斷價值的評價. 重慶醫科大學學報, 2018, 43(11): 1495-1499.
16. 張峻嘉, 邊學海. 甲狀旁腺疾病術前定位方法的比較與進展. 中國實驗診斷學, 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, 張琳, 鄧大平. ⁹⁹Tc^m-MIBI SPECT/CT 顯像在原發性甲狀旁腺功能亢進癥診斷中的價值討論. 中國輻射衛生, 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. 張悅, 張遵城, 李小東, 等. ⁹⁹Tc^m-MIBI 雙時相核素顯像在原發性甲旁亢術前定位診斷中的應用. 天津醫科大學學報, 2010, 16(4): 669-670.
22. 王晨, 趙志剛, 鄭瑞芝. 原發性甲狀旁腺功能亢進 39 例診斷及治療分析. 中華實用診斷與治療雜志, 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. 陳正國, 劉啟榆, 吳春燕, 等. SPECT/CT 融合顯像在繼發性甲狀旁腺功能亢進癥中的臨床價值. 中國臨床醫學影像雜志, 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. 黃盛, 劉曉芳, 謝飛來, 等. 術前立體定位在繼發性甲狀旁腺功能亢進癥手術中的應用. 中國普外基礎與臨床雜志, 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

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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

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