Primary hyperparathyroidism: Correlation between cervical ultrasound and MIBI scan

Area of Science:

• Endocrinology
• Nuclear Medicine
• Radiology

Background:

• Primary hyperparathyroidism (PHP) management typically involves parathyroidectomy.
• Preoperative imaging, including cervical ultrasound (US) and technetium-99m-methoxyisobutylisonitrile parathyroid scintigraphy SPECT (TC-99m-MIBI-SPECT), is crucial for locating parathyroid adenomas.

Purpose of the Study:

• To evaluate the diagnostic contribution of TC-99m-MIBI-SPECT and US in the preoperative topographic diagnosis of PHP.
• To compare the efficacy of individual imaging modalities and their combination for parathyroid adenoma localization.

Main Methods:

• A retrospective descriptive and analytical study was conducted between 2009 and 2018.
• Forty-eight patients undergoing parathyroidectomy for PHP were included.
• Cervical US and TC-99m-MIBI-SPECT data were compared with intraoperative findings and anatomopathological results.

Main Results:

• TC-99m-MIBI-SPECT identified parathyroid adenomas in 89.50% of patients, compared to 85.40% for US.
• Both US and TC-99m-MIBI-SPECT demonstrated high accuracy in predicting surgical outcomes (97.60% and 97.72%, respectively).
• The combination of both imaging techniques yielded superior sensitivity and positive predictive value.

Conclusions:

• TC-99m-MIBI-SPECT showed a higher probability of detecting solitary parathyroid adenomas than cervical US.
• Combining TC-99m-MIBI-SPECT with cervical US provides reliable preoperative localization for parathyroidectomy in PHP.