Diagnostic Performance of ^99mTc-Sestamibi SPECT/CT and ¹⁸F-Choline PET/CT in Locating Hyperfunctioning Parathyroid Glands in Patients with Primary Hyperparathyroidism

Abstract

Objective This study aimed to assess the diagnostic performance of ^99mTc-sestamibi SPECT/CT and ¹⁸F-choline PET/CT in detecting hyperfunctioning parathyroid glands in patients undergoing surgery for primary hyperparathyroidism (PHPT).

Methods A retrospective analysis was conducted on patients who underwent PHPT-related surgery between April 2019 and May 2022. The study focused on patients undergoing either ^99mTc-sestamibi SPECT/CT (81 patients) or ¹⁸F-choline PET/CT (33 patients) scans before surgery to pinpoint hyperfunctioning parathyroid gland(s). In the majority of patients, ¹⁸F-choline PET/CT was performed after negative or inconclusive findings on ^99mTc-sestamibi SPECT/CT. Pathohistological reports were utilized as the reference standard for evaluating the accuracy of the imaging findings.

Results The study encompassed 83 patients (70 females, 84.3%) with an average age of 57.2 years (24–80 years). The pathohistological analysis identified a total of 98 glands. In a per-lesion analysis, the detection rate of ^99mTc-sestamibi SPECT/CT was 57% (95% CI 45.3–68.1), while the detection rate of ¹⁸F-choline PET/CT was 90.3% (95% CI 74.3–98.0).

Conclusion The results of our study showed the significant usefulness of ¹⁸F-choline PET/CT in patients with negative or inconclusive results of ^99mTc-sestamibi SPECT/CT in accurately locating hyperfunctioning parathyroid glands in PHPT patients.

Keywords

primary hyperparathyroidism - 18F-fluorocholine - PET imaging - 99mTc-sestamibi - SPECT

^‡ Current address: University Clinical Hospital Mostar, Bijeli Brijeg bb, 88000 Mostar.

Publication History

Received: 30 November 2023
Received: 14 January 2024

Accepted: 06 February 2024

Accepted Manuscript online:
06 February 2024

Article published online:
18 March 2024

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