Min Zhang1, Lihao Sun2, Weiwei Rui3, Rui Guo1, Huihui He1, Ying Miao1, Hongping Meng1, Jianmin Liu2, Biao Li1. 1. Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. 2. Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. 3. Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Abstract
BACKGROUND: To investigate the role of 99mTc-labeled sestamibi (99mTc-MIBI) retention level in the assessment of malignant potential of parathyroid lesions. METHODS: Twenty patients with parathyroid carcinomas and forty controls with benign parathyroid lesions who underwent preoperatively 99mTc-MIBI dual-phase planar and SPECT/CT imaging were retrospectively enrolled in this study. The mean and peak of retention index (RImean and RIpeak) were measured for evaluating the retention level of 99mTc-MIBI in the parathyroid lesions. Diagnostic accuracies of RI for differentiating malignant parathyroid lesions from benign ones were assessed by receiver operating characteristic analyses (area under the curve; AUC). RESULTS: RIpeak (AUC =0.87, P<0.001) and RImean (AUC =0.78, P<0.001) showed significant difference between the malignant and benign lesions. The diagnostic sensitivity, specificity, positive and negative predictive values, accuracy of RIpeak were respectively 80.0%, 85.0%, 72.7%, 89.5% and 83.3% when its cutoff value was -19.03%. In addition, the level of serum parathyroid hormone (PTH) slightly correlated with RIpeak (r=0.260, P=0.044) or RImean (r=0.281, P=0.029). CONCLUSIONS: Parathyroid carcinomas have higher retention level of 99mTc-MIBI than benign parathyroid lesions. RIpeak may contribute to preoperative differential diagnosis of parathyroid carcinoma.
BACKGROUND: To investigate the role of 99mTc-labeled sestamibi (99mTc-MIBI) retention level in the assessment of malignant potential of parathyroid lesions. METHODS: Twenty patients with parathyroid carcinomas and forty controls with benign parathyroid lesions who underwent preoperatively 99mTc-MIBI dual-phase planar and SPECT/CT imaging were retrospectively enrolled in this study. The mean and peak of retention index (RImean and RIpeak) were measured for evaluating the retention level of 99mTc-MIBI in the parathyroid lesions. Diagnostic accuracies of RI for differentiating malignant parathyroid lesions from benign ones were assessed by receiver operating characteristic analyses (area under the curve; AUC). RESULTS: RIpeak (AUC =0.87, P<0.001) and RImean (AUC =0.78, P<0.001) showed significant difference between the malignant and benign lesions. The diagnostic sensitivity, specificity, positive and negative predictive values, accuracy of RIpeak were respectively 80.0%, 85.0%, 72.7%, 89.5% and 83.3% when its cutoff value was -19.03%. In addition, the level of serum parathyroid hormone (PTH) slightly correlated with RIpeak (r=0.260, P=0.044) or RImean (r=0.281, P=0.029). CONCLUSIONS: Parathyroid carcinomas have higher retention level of 99mTc-MIBI than benign parathyroid lesions. RIpeak may contribute to preoperative differential diagnosis of parathyroid carcinoma.
Entities:
Keywords:
99mTc-labeled sestamibi (99mTc-MIBI); Differential diagnosis; parathyroid carcinoma; retention index
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