SPECT-CT fusion in the diagnosis of hyperparathyroidism

Abstract

<em>Objective(s): </em>In this study, we aimed to analyze the relationship between the diagnostic ability of fused single photon emission computed tomography/computed tomography (SPECT/CT) images in localization of <br/>parathyroid lesions and the size of adenomas or hyperplastic glands. <br/><em>Methods: </em>Five patients with primary hyperparathyroidism (PHPT) and 4 patients with secondary hyperparathyroidism (SHPT) were imaged 15 and 120 minutes after the intravenous injection of technetium99mmethoxyisobutylisonitrile (99mTc-MIBI). All patients underwent surgery <br/>and 5 parathyroid adenomas and 10 hyperplastic glands were detected. Pathologic findings were correlated with imaging results. <br/><em>Results: </em>The SPECT/CT fusion images were able to detect all parathyroid adenomas even with the greatest axial diameter of 0.6 cm. Planar scintigraphy and SPECT imaging could not detect parathyroid adenomas <br/>with an axial diameter of 1.0 to 1.2 cm. Four out of 10 (40%) hyperplastic parathyroid glands were diagnosed, using planar and SPECT imaging and 5 out of 10 (50%) hyperplastic parathyroid glands were localized, using SPECT/CT fusion images. <br/><em>Conclusion: </em>SPECT/CT fusion imaging is a more useful tool for localization of parathyroid lesions, particularly parathyroid adenomas, in comparison with planar and or SPECT imaging.