Contribution of hybrid SPECT/CT imaging in hyperparathyroidism

Hybrid metastable technetium-99-labelled methoxyisobutyl isonitrile(99mTc-MIBI) imaging plays an important role in the diagnosis and management of hyperparathyroidism. The aim of this study is to illustrate the value of 99mTc-MIBI single-photon emission computed tomography (SPECT)/computed tomography (CT) compared with planar imaging .This prospective study included 60 patients aged 17 to 92 years, with a sex ratio of 14:1. Planar imaging showed a parathyroid adenoma in 15 cases, was normal in 44 cases, and was suspicious in one case. SPECT/CT showed a parathyroid adenoma in 30 cases, was normal in 26 cases and was suspicious in 4 cases. The two examinations were concordant in 68% of cases. SPECT/CT then showed its superiority, detecting 15 adenomas not detected by planar imaging. It also made it possible to characterize the doubtful fixation observed on planar imaging. In total, SPECT/CT made it possible to accurately locate the pathological gland in 50% of cases. This would allow the surgical procedure to be oriented towards the choice of a minimally invasive surgical technique.