Semi-quantitative analysis of 99mTc-sestamibi retention level for preoperative differential diagnosis of parathyroid carcinoma

作者：Min Zhang, Li‐hao Sun, Weiwei Rui, Rui Guo, Huihui He, Ying Miao, Hongping Meng, Jianmin Liu, Biao Li · 发表于：Quantitative Imaging in Medicine and Surgery · 年份：2019 · DOI：10.21037/qims.2019.07.02 · 被引用次数：33 · 研究领域：Parathyroid Disorders and Treatments、Medical Imaging and Pathology Studies、Pancreatic and Hepatic Oncology Research

Background: To investigate the role of 99mTc-labeled sestamibi (99mTc-MIBI) retention level in the assessment of malignant potential of parathyroid lesions. Methods: Twenty patients with parathyroid carcinomas and forty controls with benign parathyroid lesions who underwent preoperatively 99mTc-MIBI dual-phase planar and SPECT/CT imaging were retrospectively enrolled in this study. The mean and peak of retention index (RImean and RIpeak) were measured for evaluating the retention level of 99mTc-MIBI in the parathyroid lesions. Diagnostic accuracies of RI for differentiating malignant parathyroid lesions from benign ones were assessed by receiver operating characteristic analyses (area under the curve; AUC). Results: RIpeak (AUC =0.87, P<0.001) and RImean (AUC =0.78, P<0.001) showed significant difference between the malignant and benign lesions. The diagnostic sensitivity, specificity, positive and negative predictive values, accuracy of RIpeak were respectively 80.0%, 85.0%, 72.7%, 89.5% and 83.3% when its cutoff value was −19.03%. In addition, the level of serum parathyroid hormone (PTH) slightly correlated with RIpeak (r=0.260, P=0.044) or RImean (r=0.281, P=0.029). Conclusions: Parathyroid carcinomas have higher retention level of 99mTc-MIBI than benign parathyroid lesions. RIpeak may contribute to preoperative differential diagnosis of parathyroid carcinoma.