Abstract
Objectives: Primary hyperparathyroidism (PHPT) is one of the most common endocrine diseases and has parathyroidectomy (PTHx) as its sole curative treatment. The aim of this study was to evaluate the value of 99m Tc-sestaMIBI scintigraphy (99mTc-MIBI) and single-photon emission computed tomography with computed tomography (SPECT/CT), along with ultrasound (US) and to correlate surgical outcomes with pre-operative localization.
Material and methods: This retrospective and monocentric study comprised 79 patients diagnosed with primary hyperparathyroidism undergoing parathyroidectomy between 2011 and 2022 in ear nose and throat (ENT) department and endocrinology department. US, 99mTc-MIBI, and SPECT-CT were performed and their imaging data have been quantified. The diagnostic performance of imaging methods was evaluated using preoperative findings as the gold standard.
Results: Sensitivity was 74.68% for US, 87.5% for 99mTc-MIBI, 88.14 for SPECT-CT and 86.9% for associated ultrasound-scintigraphy. The sensitivity of both US and MIBI correlates with the number of pathological parathyroids. Additionally, the size of the parathyroid gland and the PTH level are positively correlated. The surgical success rate was 96.2%. There were 2 cases of persistence primary hyperparathyroidism and one case of recurrence.
Conclusion: The combination of ultrasound-99mTc-sestamibi-scintigraphy provided a higher sensitivity and specificity
Key words: primary hyperparathyroidism, imaging, ultrasound, sestamibi, concordance, parathyroidectomy
