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J Cancer 2024; 15(7):1863-1869. doi:10.7150/jca.91483 This issue Cite

Research Paper

Comparative Analysis of Diagnostic Efficacy in Primary Hyperparathyroidism: A Comparison Analysis of ¹¹C-Choline PET/CT, Neck Ultrasonography, ^99mTc-MIBI Dual-Phase Planar Scintigraphy, and ^99mTc-MIBI SPECT/CT Imaging

ZhiNing Zhang, Min Zhao, Bin Chen, YiMing Cao^✉, Shi Gao^✉

Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun 130033, China.

✉ Corresponding authors: YiMing Cao, MD & PhD, Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun 130033, China. Tel: + 86 0431 849 95196; fax: + 86 0431 846 51636; E-mail: cym947836185com. Shi Gao, MD & PhD, Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun 130033, China. Tel: + 86 0431 849 95196; fax: + 86 0431 846 51636; E-mail: gaoshiedu.cn. More

Abstract

Objective: To compare the diagnostic efficacy of ¹¹C-choline PET/CT, neck ultrasonography, ^99mTc-MIBI dual-phase planar scintigraphy, and ^99mTc-MIBI SPECT/CT imaging in the diagnosis of primary hyperparathyroidism (PHPT).

Methods: We conducted a retrospective analysis of 32 patients with PHPT who visited the Nuclear Medicine Department of Jilin University China-Japan Union Hospital between January 2019 and December 2022. All patients underwent ¹¹C-choline PET/CT, neck ultrasonography, ^99mTc-MIBI dual-phase planar scintigraphy, and ^99mTc-MIBI SPECT/CT examinations within two months before surgery. Sensitivity, specificity, positive predictive value, and negative predictive value of each imaging study were compared using postoperative pathology and follow-up results. Diagnostic efficacy was further analyzed using ROC curve analysis. Factors influencing on ^99mTc-MIBI imaging were also investigated.

Results: A total of 35 lesions were resected in the 32 patients. The diagnostic sensitivity of ¹¹C-choline PET/CT, neck ultrasonography, ^99mTc-MIBI dual-phase planar scintigraphy, and ^99mTc-MIBI SPECT/CT was 88.2%, 52.9%, 58.8%, and 67.6%, respectively. Specificity was 96.8%, 95.7%, 96.8%, and 95.7%, respectively. Positive predictive values were 90.9%, 81.8%, 86.9%, and 85.2%, respectively, and negative predictive values were 95.7%, 84.9%, 86.7%, and 89.1%, respectively. The areas under the ROC curve (AUC) were 0.925, 0.743, 0.778, and 0.817, respectively. Among them, ¹¹C-choline PET/CT had higher sensitivity and AUC than other imaging studies (p<0.05), while specificity, positive predictive value, and negative predictive value were similar (p>0.05). The positive group in ^99mTc-MIBI SPECT/CT imaging had significantly larger lesion diameters than the negative group (P<0.05), while preoperative blood calcium and PTH showed no statistical differences (P>0.05).

Conclusion: ¹¹C-choline PET/CT demonstrates superior preoperative diagnostic efficacy for PHPT compared to neck ultrasonography, ^99mTc-MIBI dual-phase planar scintigraphy, and ^99mTc-MIBI SPECT/CT. Lesion size may be the primary factor affecting the sensitivity of ^99mTc-MIBI imaging.

Keywords: primary hyperparathyroidism, ¹¹C-choline, ^99mTc-MIBI, neck ultrasonography, SPECT, PET

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