Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Ma, Junhao; Yang, Jun; Chen, Chuanzhi; Lu, Yimin; Mao, Zhuochao; Wang, Haohao; Yang, Yan; Li, Zhongqi; Wang, Weibin; Teng, Lisong

doi:10.21037/qims-21-66

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…Thus, it might be helpful to reduce the subjectivity in MIBI image evaluation and include less experienced readers for the examination. Some clinical researchers also use semi-quantitative approach for parathyroid imaging, with reasonably good results [27,28]. The washout technique can provide a diagnostic gain.…”

Section: Discussionmentioning

confidence: 99%

Interobserver Agreement of visual and semi-quantitative methods in 99mTc-Methoxy-Isobuty-Isonitrile (MIBI) imaging for risk stratification of hypofunctional thyroid nodules

Schenke,

Kreissl,

Vogel

et al. 2024

Nuklearmedizin

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Aim 99mTc-Methoxy-Isobuty-Isonitrile (MIBI) imaging is used for risk stratifications of hypofunctioning thyroid nodules (TNs). MIBI uptake in the nodular tissue is compared to the uptake in the paranodular thyroid tissue. MIBI imaging may be interpreted visually and/or semi-quantitatively. This study aimed to evaluate the interobserver agreement (IOA) of different methods of interpreting MIBI imaging (visual and semi-quantitative approaches). Methods MIBI imaging data from 2018 to 2020 were collected. Four readers with varying work experience prospectively evaluated MIBI images (planar, SPECT/CT) visually and semi-quantitatively (Wash-Out Index (WOI)). After identifying the nodules on 99mTc-pertechnetate scintigram, the readers evaluated MIBI imaging data by using early, late, early-to-late, and SPECT late acquisitions. Region of interests (ROIs) were defined for semi-quantitative analysis and average counts were calculated using the WOI formula (by Campenni et al.) 1 2. IOA was assessed using Fleiss Kappa, Pearson correlation and Analysis of Variance (ANOVA). Results 23 patients with hypofunctioning nodules were included. Kappa analysis revealed an IOA of 0.57 for all readers for early imaging (moderate agreement); perfect matches were found in 57%. For late imaging, the IOA was 0.48 (moderate) for all, with perfect matches in 48%. The visual pattern (early-to-late) exhibited an IOA of 0.45 for all, with perfect matches in 57%. SPECT/CT evaluation showed an overall IOA of 0.44, with perfect matches in 48%. The semi-quantitative approach WOI yielded an overall result of 0.64 (good agreement) and perfect matches in 91%. Conclusion The IOA for WOI was higher than for visual methods. The WOI is independent of the reader’s experience level. Visual analysis requires a certain level of experience from the reader.

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Section: Discussionmentioning

confidence: 99%

Interobserver Agreement of visual and semi-quantitative methods in 99mTc-Methoxy-Isobuty-Isonitrile (MIBI) imaging for risk stratification of hypofunctional thyroid nodules

Schenke,

Kreissl,

Vogel

et al. 2024

Nuklearmedizin

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“…Currently, nuclear 99m Tc-MIBI imaging is one of the most accurate and reliable means of preoperative parathyroid imaging ( 13 ). It plays an important role in HPT not only due to its high sensitivity and detection rate for localizing parathyroid tissue but also due to its ability to aid in assessing the degree of parathyroid hyperplasia before surgery and in selecting partial parathyroid tissue for preservation in situ or in autotransplantation during surgery ( 14 ). In a meta-analysis of 1,236 cases who underwent 99m Tc-MIBI single photon emission CT/CT (SPECT/CT) parathyroid imaging before PHPT, the detection rate of 99m Tc-MIBI SPECT/CT imaging for PHPT was 88% (95% CI: 84–92%) ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

99mTc-methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography parathyroid imaging in the diagnosis of functional parathyroid cysts: an initial experience

Wei,

Liu,

Yang

et al. 2024

Gland Surg

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Background Functional parathyroid cysts (FPCs) are rare and difficult to diagnose with noninvasive methods. The aim of this study was to evaluate the diagnostic value of 99m Tc-methoxyisobutylisonitrile ( 99m Tc-MIBI) single-photon emission computed tomography/computerized tomography (SPECT/CT) parathyroid imaging in the diagnosis of FPCs and to account for its performance. Methods The data from 10 patients with suspected parathyroid cysts (PCs) who underwent 99m Tc-MIBI SPECT/CT parathyroid imaging between 2012 and 2022 were retrospectively evaluated. The diagnostic value of 99m Tc-MIBI SPECT/CT parathyroid imaging for FPCs was analyzed. Results Surgical resection was performed in six cases and parathyroid puncture was performed in four cases. The sensitivity of 99m Tc-MIBI SPECT/CT for FPCs was 100.0% (3/3), with a specificity of 100.0% (7/7) and an accuracy of 100.0% (10/10). The postoperative pathological findings in three cases of FPCs were parathyroid adenoma, parathyroid adenoma with hemorrhage, and parathyroid adenoma with cystic degeneration, respectively. The diagnostic accuracy of ultrasound and CT for PCs was only 22.22% (2/9) and 25.0% (1/4), respectively, and neither modality could indicate whether the cysts were functional or not. Conclusions 99m Tc-MIBI parathyroid SPECT/CT imaging has a high value in the diagnosis of FPCs in patients with suspected PCs, and an intense ring-shaped accumulation of radioactivity in the cyst wall on 99m Tc-MIBI imaging suggests that the patient may have FPCs.

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“…There is widespread used of Technetium 99m methoxyisobutylisonitrile ( 99m Tc-MIBI) dual-phase planar imaging and single-photon emission computed tomography (SPECT) combined with computed tomography (CT)-SPECT/CT fusion imaging in PHPT and SHPT ( 12 – 14 ). It is used for the localization of hyeperfunction parathyroid glands in PHPT and significantly improved the outcomes of patients undergoing minimally invasive parathyroidectomy in PHPT and can also assist surgeons in selecting the lowest degree of PTG hyperplasia which is appropriate to autotransplantation in SHPT ( 15 ). However, there are few articles discussed about the differences between the 99m Tc-MIBI uptake in PHPT and SHPT.…”

Section: Introductionmentioning

confidence: 99%

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

Wang

Liu

et al. 2023

Front. Endocrinol.

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ObjectiveTo investigate the differences in biochemical marker levels and the extent of lesion visualization on technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) imaging between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT).MethodsNineteen patients with PHPT and 14 patients with SHPT were enrolled in the study, all of whom underwent routine 99mTc-MIBI dual-phase planar imaging, single-photon emission computed tomography combined with computed tomography (SPECT/CT fusion) imaging, and serum biochemical and hormonal investigations prior to surgery. The target-to-non-target (T/NT) ratios were calculated based on images from the early and delayed phases of 99mTc-MIBI planar imaging and also based on SPECT/CT fusion imaging. The volume of the parathyroid glands was measured following their excision.ResultsA total of 62 parathyroid glands were removed: 14 parathyroid adenomas and five parathyroid carcinomas in PHPT patients; and 18 parathyroid adenomas, 17 parathyroid hyperplasia lesions, and eight instances of nodular hyperplasia with adenoma in SHPT patients. The median volume of the lesions in PHPT and SHPT was 1.69 cm3 and 0.52 cm3 respectively, and the difference between them was statistically significant (P = 0.001). The median T/NT ratios calculated at the early phase of 99mTc-MIBI planar imaging, the delayed phase of 99mTc-MIBI planar imaging, and the subsequent SPECT/CT fusion imaging were 1.51, 1.34, and 2.75, respectively, in PHPT, and 1.46, 1.30, and 1.38, in SHPT, respectively. The T/NT ratio difference between PHPT and SHPT on the SPECT/CT fusion imaging was statistically significant (P = 0.002). The histopathology subtypes of the lesions were associated with significant differences in two areas: the T/NT ratios on the SPECT/CT fusion imaging and the volume of the lesions (P=0.002, P<0.001).ConclusionThe proportion of positive findings on 99mTc-MIBI dual-phase planar imaging and the T/NT ratios of 99mTc-MIBI SPECT/CT fusion imaging were higher in PHPT than in SHPT. The volume of parathyroid lesions in SHPT was smaller than in PHPT.

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Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Cited by 6 publications

References 32 publications

Interobserver Agreement of visual and semi-quantitative methods in 99mTc-Methoxy-Isobuty-Isonitrile (MIBI) imaging for risk stratification of hypofunctional thyroid nodules

Interobserver Agreement of visual and semi-quantitative methods in 99mTc-Methoxy-Isobuty-Isonitrile (MIBI) imaging for risk stratification of hypofunctional thyroid nodules

99mTc-methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography parathyroid imaging in the diagnosis of functional parathyroid cysts: an initial experience

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

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