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Updated: Feb 21, 2026

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Dual-isotope subtraction SPECT-CT in parathyroid localization.

Anna-May Woods1, Alison A Bolster, Sai Han

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Summary

Dual-isotope subtraction SPECT-CT accurately detects and locates parathyroid adenomas in primary hyperparathyroidism. This imaging technique demonstrates high sensitivity and specificity, proving reliable for preoperative assessment.

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Area of Science:

  • Nuclear Medicine
  • Endocrinology
  • Radiology

Background:

  • Primary hyperparathyroidism is often caused by parathyroid adenomas.
  • Accurate preoperative localization of parathyroid adenomas is crucial for successful surgical outcomes.

Purpose of the Study:

  • To evaluate the accuracy of dual-isotope subtraction single-photon emission computed tomography-computed tomography (SPECT-CT) for parathyroid adenoma detection and localization.
  • To compare SPECT-CT findings with surgical pathology and clinical follow-up.

Main Methods:

  • A retrospective study included 224 patients with primary hyperparathyroidism.
  • Patients received iodine-123-iodide and technetium-99m-sestamibi for dual-isotope subtraction SPECT-CT.
  • Imaging results were compared with pathology (115 patients) and 2-year clinical follow-up.

Main Results:

  • The study analyzed 135 patients with complete follow-up data.
  • Dual-isotope subtraction SPECT-CT showed 95% sensitivity and 89% specificity for adenoma detection.
  • The technique achieved 94% accuracy in detection and 92% in localization.

Conclusions:

  • Dual-isotope subtraction SPECT-CT is a highly sensitive and specific imaging method.
  • This technique is a reliable preoperative tool for identifying and locating parathyroid adenomas in primary hyperparathyroidism.