Optimization of SPECT/CT scan schemes in localizing preoperative parathyroid lesions / 中华核医学与分子影像杂志

ABSTRACT

Objective To compare the diagnostic efficiencies of different scanning schemes of dualphase 99Tcm-methoxyisobutylisonitrile (MIBI) planar imaging with or without SPECT/CT in the preoperative localization of parathyroid lesions.Methods Forty-two patients (20 males,22 females;average age (53.1 ± 14.8) years) with primary or secondary hyperparathyroidism who underwent parathyroidectomy from June 2011 to June 2016 were analyzed retrospectively.All patients underwent dual-phase 99Tcm-MIBI planar scan and dual-phase SPECT/CT scan.The images were collected according to the following 4 proceduresdualphase planar imaging (S1),dual-phase planar imaging+early-phase SPECT/CT (S2),dual-phase planar imaging+delayed-phase SPECT/CT (S3),dual-phase planar imaging+dual-phase SPECT/CT (S4).Pathological results were considered as the gold standard.A total of 168 parathyroid glands in 42 patients were evaluated by the 4 imaging procedures respectively.The diagnostic efficiencies were calculated and compared by x2 test.Results Seventy-eight abnormal parathyroid lesions were found.The diagnostic sensitivities of S1,S2,S3,S4 were 66.7％ (52/78),89.7％(70/78),69.2％(54/78),89.7％(70/78),and the accuracies were 78.6％ (132/168),94.0％ (158/168),85.1％ (143/168),94.0％ (158/168),respectively.The diagnostic accuracies of S2 and S4 were significantly higher than those of S1 and S3 (x2 values17.027 and 7.176,both P＜0.01).Condusions The dual-phase planar imaging together with early-phase and dualphase SPECT/CT imaging have high diagnostic efficiencies in the preoperative localization of parathyroid lesions.Considering reducing radiation dose and examine time,the dual-phase planar imaging together with early-phase SPECT/CT is a better choice.