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

Overview

Journal J Cancer

Specialty Oncology

Date 2024 Mar 4

PMID 38434973

Authors

Zhining Zhang

Min Zhao

Bin Chen

Yiming Cao

Shi Gao

Affiliations

Soon will be listed here.

Abstract

To compare the diagnostic efficacy of C-choline PET/CT, neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-MIBI SPECT/CT imaging in the diagnosis of primary hyperparathyroidism (PHPT). 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 C-choline PET/CT, neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-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 Tc-MIBI imaging were also investigated. A total of 35 lesions were resected in the 32 patients. The diagnostic sensitivity of C-choline PET/CT, neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-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, C-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 Tc-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). C-choline PET/CT demonstrates superior preoperative diagnostic efficacy for PHPT compared to neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-MIBI SPECT/CT. Lesion size may be the primary factor affecting the sensitivity of Tc-MIBI imaging.

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