Ultrasound and 99mTc-MIBI Scintigraphy in Differentiating between Parathyroid Hyperplasia and Parathyroid Adenoma

Abstract

Background Different pathological types of parathyroid lesions determine the choice of treatment and prognosis. Ultrasound and 99mTc-MIBI scintigraphy techniques have been widely used in the diagnosis of parathyroid lesions. Studies have shown that ultrasound and radionuclide manifestations of parathyroid lesions differ by the pathological type, but how to extract the characteristic indices of various types of parathyroid lesions from many ultrasound features and 99mTc-MIBI scintigraphy is a difficulty of current research. Objective To compare the value of ultrasound versus 99mTc-MIBI scintigraphy in differentiating between parathyroid hyperplasia (PH) and parathyroid adenoma (PA) by analyzing the features of PH and PA measured by them. Methods One hundred and fifty patients with 199 thyroid lesions in total who underwent parathyroidectomy in First Affiliated Hospital, School of Medicine, Shihezi University from February 2016 to March 2022 were selected. Parathyroid ultrasound and 99mTc-MIBI scintigraphy were performed before operation, and the detected results by them were comparatively assessed with postoperative pathological findings as the gold standard for reference. The receiver operating characteristic (ROC) analysis was used to estimate the value of the two modalities in differentiating between PH and PA. Results Compared with 99mTc-MIBI scintigraphy, ultrasound had higher sensitivity (82.14% vs 50.00%) , specificity (89.51% vs 64.34%) , accuracy (87.43% vs 60.30%) and larger area under the ROC curve (0.885 vs 0.775) (P<0.05) in differentiating between PH and PA. Conclusion Both ultrasound and 99mTc-MIBI scintigraphy could differentiate between PA and PH, but the performance of ultrasound was better

Keywords

• parathyroid diseases|ultrasound|99mtc-mibi imaging|parathyroid hyperplasia|parathyroid adenoma