Haghighatafshar Mahdi, Farhoudi Farinaz
From the Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran (MH, FF).
Medicine (Baltimore). 2016 Jan;95(2):e2498. doi: 10.1097/MD.0000000000002498.
The 99mTc-MIBI has been used with great value as a diagnostic technique in patients with primary hyperparathyroidism. False-positive scans may occur due to misinterpretation of the physiologic distribution of the 99mTc-MIBI. Reviewing consecutive SPECT scans, we evaluated this possibility and assessed how frequently brown adipose tissue (BAT) is seen on 99mTc-MIBI scintigraphy. Here, we retrospectively reviewed scans of consecutive patients who were evaluated for parathyroid adenomas from March 2015 to June 2015, using dual-phase (early and delayed) planar imaging and SPECT. We identified 60 patients (48 female and 12 male; mean age, 52.25 ± 15.20 years; range, 22-86 years).We detected the presence of 99mTc-MIBI uptake in BAT in 20 of 60 patients (33.33%) in the neck. Although the patients with T99mc-MIBI uptake in BAT were younger (mean age, 48.85 ± 15.27 years, range, 26-73 years) than the patients with no 99mTc-MIBI uptake (mean age, 53.95 ± 15.07 years, range, 22-86 years), this difference was not statistically significant (P = 0.224). The percentage of female patients with BAT detection was higher (17/48 patients; 37.5%) than that of the male population (3/12 patients; 25%), this difference was not also statistically significant (P = 0.85).In patient population referred to 99mTc MIBI scintigraphy of the parathyroid glands, uptake of 99mTc-MIBI in BAT should not be misinterpreted with 99mTc-MIBI-avid-tumors. Fused SPECT/CT images (not SPECT-only) are necessary to distinguish BAT from bone, muscle, thyroid, myocardium, parathyroids, and other structures in the neck and chest.
99mTc-MIBI作为原发性甲状旁腺功能亢进患者的一种诊断技术，具有很高的应用价值。由于对99mTc-MIBI生理分布的错误解读，可能会出现假阳性扫描结果。通过回顾连续的SPECT扫描，我们评估了这种可能性，并评估了在99mTc-MIBI闪烁扫描中棕色脂肪组织（BAT）出现的频率。在此，我们回顾性分析了2015年3月至2015年6月期间因甲状旁腺腺瘤接受评估的连续患者的扫描结果，采用双期（早期和延迟）平面成像和SPECT。我们确定了60例患者（48例女性和12例男性；平均年龄52.25±15.20岁；范围22-86岁）。我们在60例患者中的20例（33.33%）颈部检测到BAT中有99mTc-MIBI摄取。虽然BAT中摄取99mTc-MIBI的患者（平均年龄48.85±15.27岁，范围26-73岁）比未摄取99mTc-MIBI的患者（平均年龄53.95±15.07岁，范围22-86岁）年轻，但这种差异无统计学意义（P=0.224）。检测到BAT的女性患者百分比（17/48例患者；37.5%）高于男性患者（3/12例患者；25%），这种差异也无统计学意义（P=0.85）。在接受甲状旁腺99mTc MIBI闪烁扫描的患者群体中，不应将BAT中99mTc-MIBI的摄取误解为99mTc-MIBI摄取性肿瘤。需要融合的SPECT/CT图像（而非仅SPECT图像）来区分BAT与颈部和胸部的骨骼、肌肉、甲状腺、心肌、甲状旁腺及其他结构。
