Quantitative analysis in parathyroid adenoma scintigraphy. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Havel, Martin; Dedek, Vladimir; Kolacek, Michal; Formanek, Martin
• Is Part Of: Nuclear medicine communications. Volume 43:Issue 1(2022)
• Publication Date: 2022-01
• Subjects: adenoma -- emission-computed -- minimally invasive surgical procedures -- parathyroid neoplasms -- radionuclide imaging -- single-photon -- tomography; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000001474
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Objective: Surgery is the only curative treatment for primary hyperparathyroidism. Parathyroid scintigraphy is one method used to preoperatively localize the lesion. We examined time-related changes in radiopharmaceutical uptake in parathyroid adenomas (PTAs) and thyroid gland by quantitative single-photon-emission computed tomography (SPECT) imaging to assess differences between rapid and delayed washout patterns. Patients and methods: The study group consisted of 35 histologically verified PTAs after radio-guided surgery extirpation in 33 patients with primary hyperparathyroidism. Patients underwent a three-phase SPECT/CT study of the neck and upper thorax post 99m Tc-methoxyisobutylisonitrile (MIBI) injection. Images were reconstructed using a proprietary ordered-subset-conjugate-gradient-maximization algorithm (Siemens xSPECT Quant). PTAs were divided into those with a rapid (group A) and those with a slow (group B) washout pattern. SUVmax values of PTAs and thyroid gland tissue at 10, 90 and 180 min post 99m Tc-MIBI injection were recorded and statistically assessed. Retention indexes related to the early examination were calculated for PTA and thyroid gland (RI-PTA and RI-TG). Results: There were 11 PTAs in group A and 24 in group B. Significant between-group differences in PTA SUVmax and PTA/thyroid gland ratios were observed only at 180 min postinjection ( P = 0.0297, P = 0.0222, respectively). RI-PTAs differed significantly at 90 and 180 min postinjection ( P = 0.0298, P = 0.0431). No differences in PTA volumes, thyroid gland SUVmax values or RI-TG were observed between the groups. Conclusion: PTAs with rapid and slow washout patterns have different characteristics on quantitative analysis in later phases. No significant differences in directly measurable quantitative values (SUVmax, PTA/thyroid gland ratio) at the early stages of multi-phase examination were observed.