Bone uptake of Tc-99m MIBI in patients with hyperparathyroidism

Zhao, Yongming; Wang, Qian

doi:10.1007/s12149-014-0818-9

Cited by 15 publications

(11 citation statements)

References 12 publications

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“…Qui et al [ 22 ] have described the detection of vertebral metastases on a MIBI scan, in a patient with a rare parathyroid carcinoma. Zhao and Wang [ 23 ] have highlighted the relation between a high level of intact PTH and bone uptake of MIBI, concluding that this could reflect a stage of metabolic bone disease.…”

Section: Discussionmentioning

confidence: 99%

Incidentalomas during imaging for primary hyperparathyroidism—incidence and clinical outcomes

et al. 2015

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BackgroundImaging for pre-operative localisation of parathyroid glands in primary hyperparathyroidism is now routine. This has led to the detection of incidental lesions (incidentalomas) in other organs, the nature of which is not well characterised.The aim of this study was to determine the incidence, characteristics and outcomes in patients who had incidental findings on parathyroid imaging.MethodsRecords of patients who underwent imaging for primary hyperparathyroidism over 2 years were reviewed to identify incidental lesions detected on parathyroid imaging. Patients with persistent or renal hyperparathyroidism were excluded. Details on the management of detected incidentalomas were obtained from patient records.ResultsIncidentalomas were identified in 17 of 170 patients (10 %) undergoing parathyroid imaging. Incidentalomas included thyroid (n = 11), breast (n = 3), lateral compartment of the neck (n = 1), lung (n = 1) and clavicle (n = 1). However, no disease of clinical significance needing treatment was detected on further investigation.ConclusionsAlthough a significant proportion of patients undergoing parathyroid imaging had incidental lesions detected, these seem to be of little clinical significance. The morbidity and cost of further interventions on these incidentalomas need to be weighed against the benefits of routine imaging in improving outcomes of first-time surgery in patients with primary hyperparathyroidism.

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Section: Discussionmentioning

confidence: 99%

Incidentalomas during imaging for primary hyperparathyroidism—incidence and clinical outcomes

et al. 2015

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“…One false positive lesion found on the 99m Tc-MIBI scintigraphy was the focal 99m Tc-MIBI uptake of the manubrium sterni. Previous study supposed that the 99m Tc-MIBI uptake of bone might reflect the presence of active metabolic bone disease, but did not reflect the changes that occurred in microstructure of bone [40]. However, this remains to be evaluated further.…”

Section: Discussionmentioning

confidence: 87%

Diagnosis performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT in preoperative localization of parathyroid gland in secondary hyperparathyroidism

Zhang

Huang

et al. 2020

Preprint

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Background: Secondary hyperparathyroidism (SHPT) usually need parathyroidectomy when drug regimens fail. However, obtaining an exact preoperative map of the locations of the parathyroid glands is a challenge. The purpose of this study was to compare the diagnostic performance of ultrasonography, dual-phase 99m Tc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT in patients with SHPT. Methods: Sixty patients with SHPT who were undergoing dialysis were evaluated preoperatively with ultrasonography, dual-phase 99m Tc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT. Postoperative pathology served as the gold standard. The sensitivity, specificity, and accuracy rate were determined for each method. Spearman correlation analysis was used to analyze the correlation of the hyperplastic parathyroid calcification with serum alkaline phosphatase (AKP) and parathyroid hormone (PTH). Results: 229 lesions in 60 patients were pathological confirmed to be parathyroid hyperplasia with 209 lesions in typical sites, 15 lesions in upper mediastinum and 5 lesions in the thyroid. 88.33% (53/60) patients had four lesions. US, early and delayed SPECT/CT had significantly higher sensitivity and accuracy rate (P < 0.001) than did dual-phase 99m Tc-MIBI scintigraphy. Furthermore, early SPECT/CT had significantly higher sensitivity (χ2 = 17.521, P < 0.001, χ2 = 35.027, P < 0.001) and accuracy rate (χ2 = 11.076, P = 0.001, χ2 = 16.289, P < 0.001) than did US and delayed SPECT/CT. In ectopic hyperplastic parathyroid, the sensitivity of early SPECT/CT (90%) was significantly higher than US (55%) and dual-phase planar (50%) (P = 0.039 and P = 0.039). Spearman correlation results showed a significant linear association between the calcification and serum PTH (r = 0.398, P = 0.002) and AKP (r = 0.415, P = 0.002). Conclusion: The ability of early SPECT/CT to detect hyperplastic parathyroid in patients with SHPT is superior to US, 99m Tc-MIBI scintigraphy and delayed SPECT/CT, and dual-phase SPECT/CT is not essential. Calcification of parathyroid gland is related to the levels of PTH and AKP and may help provide an evidence for the identification of SHPT.

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“…One false-positive lesion found on dual-phase 99m Tc-MIBI scintigraphy was attributed to the focal 99m Tc-MIBI uptake of the manubrium sterni. A previous study suggested that the 99m Tc-MIBI uptake of bone might reflect the presence of active metabolic bone disease but did not reflect changes that occurred in the microstructure of bone [42]. However, this remains to be evaluated further.…”

Section: Discussionmentioning

confidence: 89%

Diagnostic performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism

Zhang

Huang

et al. 2020

BMC Med Imaging

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Background: Secondary hyperparathyroidism (SHPT) usually requires parathyroidectomy when drug regimens fail. However, obtaining an exact preoperative map of the locations of the parathyroid glands is a challenge. The purpose of this study was to compare the diagnostic performance of US, dual-phase 99m Tc-MIBI scintigraphy, early and delayed 99m Tc-MIBI SPECT/CT in patients with SHPT. Methods: Sixty patients with SHPT who were undergoing dialysis were evaluated preoperatively by US, dual-phase 99m Tc-MIBI scintigraphy, early and delayed 99m Tc-MIBI SPECT/CT. Postoperative pathology served as the gold standard. The sensitivity, specificity, and accuracy were determined for each method. Spearman correlation analysis was used to analyse the correlation of hyperplastic parathyroid calcification with serum alkaline phosphatase (ALP) and parathyroid hormone (PTH). Results: A total of 229 lesions in 60 patients were pathologically confirmed to be parathyroid hyperplasia, with 209 lesions in typical sites, 15 lesions in the upper mediastinum and 5 lesions in the thyroid. A total of 88.33% (53/60) of patients had four lesions. US, early and delayed 99m Tc-MIBI SPECT/CT had significantly higher sensitivity and accuracy than dual-phase 99m Tc-MIBI scintigraphy (P < 0.001). Furthermore, early 99m Tc-MIBI SPECT/CT had significantly higher sensitivity (P < 0.001) and accuracy (P = 0.001 and P < 0.001) than US and delayed 99m Tc-MIBI SPECT/CT. In patients with ectopic hyperplastic parathyroid glands, the sensitivity of early 99m Tc-MIBI SPECT/CT (90%) was significantly higher than that of US (55%) and dual-phase 99m Tc-MIBI scintigraphy (50%) (P < 0.05). The Spearman correlation results showed a significant albeit weak association between calcification and both serum PTH and ALP (P = 0.002).

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Bone uptake of Tc-99m MIBI in patients with hyperparathyroidism

Abstract: Bone uptake of MIBI in patients with HPT is commonly related to a high level of iPTH and ALP; it probably reflects an active stage of MBD, and it should be monitored during the conventional Tc-99m MIBI scintigraphy.

Cited by 15 publications

References 12 publications

Incidentalomas during imaging for primary hyperparathyroidism—incidence and clinical outcomes

Incidentalomas during imaging for primary hyperparathyroidism—incidence and clinical outcomes

Diagnosis performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early SPECT/CT and delayed SPECT/CT in preoperative localization of parathyroid gland in secondary hyperparathyroidism

Diagnostic performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism

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