Institute of Nuclear Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168, Rome, Italy.
Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Via E. Chianesi 53, 00144, Rome, Italy.
J Endocrinol Invest. 2022 Nov;45(11):2139-2147. doi: 10.1007/s40618-022-01847-x. Epub 2022 Jul 6.
Parathyroid scintigraphy is mandatory for the identification of hyperfunctioning parathyroid glands in hyperparathyroidism (HPT). The use of Tc-methoxy-isobutyl-isonitrile (MIBI) as radiopharmaceutical for parathyroid scintigraphy is considered the most valid and useful considering its uptake mechanism. Several MIBI-based radiopharmaceuticals are commercially available (i.e., MediMIBI, TechneMIBI, Stamicis). They seem to have similar physico-chemical characteristics and the choice between them is based on commercial criteria, even though some differences in qualitative scintigraphic results have been appreciated. Aims of the study were: first, to compare the scintigraphic quantitative data of MediMIBI, TechneMIBI, and Stamicis, particularly in the view of a personalized medicine approach; second, to investigate the potential effect of clinical-laboratory data on image quality using one of these radiopharmaceuticals.
Patients with diagnosis of HPT, who underwent a parathyroid scintigraphy using one of the three MIBI-based radiopharmaceuticals between December 2018 and October 2020, have been retrospectively identified. Parameters derived from regions of interest (ROIs) drawn on three different sites were obtained: a reasonable parathyroid lesion detected, an area in the lateral neck considered as the background, and the hepatic dome as the site of MIBI physiological uptake. Laboratory and clinical data, such as serum calcium, PTH, vitamin D, and creatinine levels, as well as possible drug-mediated interferences were considered.
Among 250 patients included, 83 (33.2%) had the parathyroid scintigraphy using MediMIBI, 84 (33.6%) using TechneMIBI and 83 (33.2%) using Stamicis. The ROIs on the parathyroid uptake at early images, on the background, and on the hepatic dome were statistically different among the three groups (p < 0.05). No significant differences were found in the remaining semi-quantitative parameters among the three groups, not even considering clinical-laboratory data.
Some differences in semi-quantitative parameters emerged among MIBI-based radiopharmaceuticals for parathyroid scintigraphy. This might justify the different qualitative scintigraphic results obtained using one or another of the cited radiopharmaceuticals.
甲状旁腺闪烁显像是甲状旁腺功能亢进症（HPT）中识别功能亢进的甲状旁腺所必需的。放射性药物 Tc-甲氧基异丁基异腈（MIBI）的使用被认为是最有效和最有用的，因为它的摄取机制。有几种基于 MIBI 的放射性药物在商业上可用（即 MediMIBI、TechneMIBI、Stamicis）。它们似乎具有相似的理化特性，它们之间的选择基于商业标准，尽管在定性闪烁显像结果方面已经注意到了一些差异。本研究的目的是：首先，比较 MediMIBI、TechneMIBI 和 Stamicis 的闪烁显像定量数据，特别是从个体化医学的角度；其次，研究使用其中一种放射性药物时临床-实验室数据对图像质量的潜在影响。
回顾性确定了 2018 年 12 月至 2020 年 10 月期间使用三种基于 MIBI 的放射性药物中的一种进行甲状旁腺闪烁显像的 HPT 患者。从三个不同部位绘制的感兴趣区域（ROI）中获得了以下参数：合理检测到的甲状旁腺病变、颈侧的区域作为背景，以及肝脏穹顶作为 MIBI 生理摄取的部位。考虑了实验室和临床数据，如血清钙、PTH、维生素 D 和肌酐水平，以及可能的药物介导的干扰。
在纳入的 250 例患者中，83 例（33.2%）接受了 MediMIBI 甲状旁腺闪烁显像，84 例（33.6%）接受了 TechneMIBI 甲状旁腺闪烁显像，83 例（33.2%）接受了 Stamicis 甲状旁腺闪烁显像。在早期图像上的甲状旁腺摄取、背景和肝穹顶的 ROI 之间，三组之间存在统计学差异（p<0.05）。在三组之间，即使考虑了临床-实验室数据，其余半定量参数也没有发现显著差异。
甲状旁腺闪烁显像中使用的基于 MIBI 的放射性药物之间存在一些半定量参数差异。这可能解释了使用其中一种放射性药物获得的不同定性闪烁显像结果。
