The Relationship between Planar and SPECT/CT Parameters and Functional Markers in Primary Hyperparathyroidism

Area of Science:

• Nuclear Medicine
• Endocrinology
• Radiology

Background:

• Primary hyperparathyroidism (PHPT) is a condition characterized by excessive parathyroid hormone production.
• Accurate assessment of PHPT severity often relies on biochemical markers and imaging.
• Technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) SPECT/CT is a key imaging modality for parathyroid adenoma localization.

Purpose of the Study:

• To investigate the correlation between quantitative and volumetric SPECT/CT imaging parameters and hormonal/biochemical markers in PHPT patients with single adenoma.
• To evaluate the utility of these parameters, particularly the parathormone/adenoma volume (PTH/Svol) ratio, in predicting disease severity.

Main Methods:

• Retrospective analysis of 70 PHPT patients with single adenomas undergoing 99mTc-MIBI SPECT/CT.
• Calculation of planar scintigraphy parameters (eLBR, dLBR, eLTR, dLTR, RI) and SPECT/CT-derived parameters (adenoma volume [Svol], PTH/Svol ratio).
• Correlation analysis between imaging parameters and biochemical markers (calcium, PTH, phosphorus).

Main Results:

• Calcium levels positively correlated with eLBR, dLBR, dLTR, and PTH/Svol ratio.
• PTH/Svol ratio showed a negative correlation with phosphorus levels.
• The PTH/Svol ratio demonstrated comparable diagnostic performance to PTH and phosphorus for disease severity prediction, outperforming eLBR and dLBR.

Conclusions:

• Both planar and SPECT/CT imaging parameters offer valuable insights into parathyroid adenoma function and disease severity in PHPT.
• The PTH/Svol ratio effectively integrates imaging and laboratory data, presenting a promising indicator for comprehensive patient management.
• This combined approach may enhance the assessment and treatment strategies for PHPT patients.