Elif Tutku Durmuş1, Ayşegül Atmaca2, Mehmet Kefeli3, Özgür Mete4,5, Fevziye Canbaz Tosun6, Deniz Bayçelebi3, Cafer Polat7, Ramis Çolak2. 1. Department of Endocrinology and Metabolism, School of Medicine, Ondokuz Mayis University, Samsun, Turkey. tutkueser@yahoo.com. 2. Department of Endocrinology and Metabolism, School of Medicine, Ondokuz Mayis University, Samsun, Turkey. 3. Department of Pathology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey. 4. Department of Pathology, University Health Network, Toronto, Ontario, Canada. 5. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. 6. Department of Nuclear Medicine, School of Medicine, Ondokuz Mayis University, Samsun, Turkey. 7. Department of General Surgery, School of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Abstract
PURPOSE: Technetium-99 m sestamibi parathyroid scintigraphy (MIBI scan) has been used to localize abnormal glands in patients with primary hyperparathyroidism to guide parathyroidectomy. This series aimed to identify the biochemical and histopathological correlates of MIBI scan findings in patients with parathyroid adenoma. METHODS: A total of 378 patients with histologically and biochemically proven parathyroid adenoma were included. The results of MIBI scan, histopathological (gland volume and weight, oxyphil cell ratio), biochemical (blood and 24 h urine calcium, creatinine, glomerular filtration rate, parathormone, alkaline phosphate, and vitamin D3) variables were recorded. A positive uptake on the MIBI scan referred to a localized adenoma. Among histological variables, a cutoff of 30% was applied to define parathyroid adenomas with low (≤ 30%) and high (> 30%) oxyphil cell content. Statistical analyses were performed to assess the relationship among variables. RESULTS: MIBI scan localized the adenoma in 306 patients. Parathyroid gland volume and weight, and oxyphil ratio were significantly higher in the MIBI scan-positive group. Among the biochemical variables, only PTH was found to be significantly increased in the MIBI scan-positive group. Binary logistic regression models identified statistically significant cutoffs for the gland volume (1700 mm3), gland weight (1.3 g) and PTH levels (170 pg/mL) that can be used to predict the MIBI scan positivity. CONCLUSION: In addition to PTH levels, this series underscored the impact of cellular composition along with the parathyroid gland volume and weight, both of which correlate with sestamibi positivity in patients with benign uniglandular parathyroid disease.
PURPOSE: Technetium-99 m sestamibi parathyroid scintigraphy (MIBI scan) has been used to localize abnormal glands in patients with primary hyperparathyroidism to guide parathyroidectomy. This series aimed to identify the biochemical and histopathological correlates of MIBI scan findings in patients with parathyroid adenoma. METHODS: A total of 378 patients with histologically and biochemically proven parathyroid adenoma were included. The results of MIBI scan, histopathological (gland volume and weight, oxyphil cell ratio), biochemical (blood and 24 h urine calcium, creatinine, glomerular filtration rate, parathormone, alkaline phosphate, and vitamin D3) variables were recorded. A positive uptake on the MIBI scan referred to a localized adenoma. Among histological variables, a cutoff of 30% was applied to define parathyroid adenomas with low (≤ 30%) and high (> 30%) oxyphil cell content. Statistical analyses were performed to assess the relationship among variables. RESULTS: MIBI scan localized the adenoma in 306 patients. Parathyroid gland volume and weight, and oxyphil ratio were significantly higher in the MIBI scan-positive group. Among the biochemical variables, only PTH was found to be significantly increased in the MIBI scan-positive group. Binary logistic regression models identified statistically significant cutoffs for the gland volume (1700 mm3), gland weight (1.3 g) and PTH levels (170 pg/mL) that can be used to predict the MIBI scan positivity. CONCLUSION: In addition to PTH levels, this series underscored the impact of cellular composition along with the parathyroid gland volume and weight, both of which correlate with sestamibi positivity in patients with benign uniglandular parathyroid disease.
Authors: Astrid Geysen; Brigitte Decallonne; Vincent Vander Poorten; Christophe M Deroose; Koen Van Laere; Karolien Goffin; Sander Jentjens Journal: Am J Nucl Med Mol Imaging Date: 2021-06-15