Kairemo Kalevi, Jessop Aaron C, Vija A Hans, Ding Xinhong, Spence Don, Kappadath S Cheenu, Macapinlac Homer A
Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Theragnostics, Docrates Cancer Center, 00180 Helsinki, Finland.
Diagnostics (Basel). 2021 Oct 28;11(11):2006. doi: 10.3390/diagnostics11112006.
Thirty-one consecutive patients were included in this study who were planned for parathyroidectomy due to primary hyperparathyroidism. They were studied with US, 4D-CT and dual-phase scintigraphy including SPECT/CT, and possible adenomas were identified in each imaging modality. Imaging data were quantified with US, CT and SPECT. Parathyroidectomies were performed as minimally invasive according to preoperative imaging findings. A total of 16 adenomas were found in 15 patients, and the surgery was negative in four patients. The imaging results were compared with each other and correlated to histology findings and blood biochemistry (S-Ca and P-PTH). Quantitative SPECT found a strong correlation between the quantification methods-Conjugate Gradient with Attenuation and Scatter Correction with a zone map (CGZAS) and Conjugate Gradient with Attenuation and Scatter Correction (CGAS)-measured as SUVmax and kBq/mL. However, a statistically significant correlation between the quantitative parameters (CGZAS and CGAS) and serum biomarkers (S-PTH and S-Ca) was not observed. The sensitivities of the imaging methods were calculated using histopathology as a gold standard. SPECT/CT demonstrated 93% sensitivity, 4D-CT 93% sensitivity and ultrasonography 73% sensitivity. The imaging methods were compared with each other using parathyroid regions because findings and locations varied between the modalities. Our prospective study supports that quantitative SPECT/CT is useful for presurgical assessment of primary hyperparathyroidism.
本研究纳入了31例因原发性甲状旁腺功能亢进计划行甲状旁腺切除术的连续患者。对他们进行了超声、四维CT和包括SPECT/CT在内的双期闪烁扫描检查，并在每种成像方式中识别出可能的腺瘤。利用超声、CT和SPECT对成像数据进行量化。根据术前成像结果，以微创方式进行甲状旁腺切除术。15例患者共发现16个腺瘤，4例患者手术结果为阴性。将成像结果相互比较，并与组织学结果和血液生化指标（血清钙和甲状旁腺激素）相关联。定量SPECT发现，以SUVmax和kBq/mL衡量，量化方法——带衰减和散射校正的共轭梯度法与区域图（CGZAS）和带衰减和散射校正的共轭梯度法（CGAS）之间存在强相关性。然而，未观察到定量参数（CGZAS和CGAS）与血清生物标志物（血清甲状旁腺激素和血清钙）之间存在统计学显著相关性。以组织病理学为金标准计算成像方法的敏感性。SPECT/CT的敏感性为93%，四维CT的敏感性为93%，超声检查的敏感性为73%。由于不同成像方式的发现和位置不同，因此利用甲状旁腺区域对成像方法进行相互比较。我们的前瞻性研究支持定量SPECT/CT对原发性甲状旁腺功能亢进的术前评估有用。
