Zhang ZhiNing, Zhao Min, Chen Bin, Cao YiMing, Gao Shi
Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
J Cancer. 2024 Feb 4;15(7):1863-1869. doi: 10.7150/jca.91483. eCollection 2024.
To compare the diagnostic efficacy of C-choline PET/CT, neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-MIBI SPECT/CT imaging in the diagnosis of primary hyperparathyroidism (PHPT). We conducted a retrospective analysis of 32 patients with PHPT who visited the Nuclear Medicine Department of Jilin University China-Japan Union Hospital between January 2019 and December 2022. All patients underwent C-choline PET/CT, neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-MIBI SPECT/CT examinations within two months before surgery. Sensitivity, specificity, positive predictive value, and negative predictive value of each imaging study were compared using postoperative pathology and follow-up results. Diagnostic efficacy was further analyzed using ROC curve analysis. Factors influencing on Tc-MIBI imaging were also investigated. A total of 35 lesions were resected in the 32 patients. The diagnostic sensitivity of C-choline PET/CT, neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-MIBI SPECT/CT was 88.2%, 52.9%, 58.8%, and 67.6%, respectively. Specificity was 96.8%, 95.7%, 96.8%, and 95.7%, respectively. Positive predictive values were 90.9%, 81.8%, 86.9%, and 85.2%, respectively, and negative predictive values were 95.7%, 84.9%, 86.7%, and 89.1%, respectively. The areas under the ROC curve (AUC) were 0.925, 0.743, 0.778, and 0.817, respectively. Among them, C-choline PET/CT had higher sensitivity and AUC than other imaging studies (p<0.05), while specificity, positive predictive value, and negative predictive value were similar (p>0.05). The positive group in Tc-MIBI SPECT/CT imaging had significantly larger lesion diameters than the negative group (P<0.05), while preoperative blood calcium and PTH showed no statistical differences (P>0.05). C-choline PET/CT demonstrates superior preoperative diagnostic efficacy for PHPT compared to neck ultrasonography, Tc-MIBI dual-phase planar scintigraphy, and Tc-MIBI SPECT/CT. Lesion size may be the primary factor affecting the sensitivity of Tc-MIBI imaging.
比较C-胆碱PET/CT、颈部超声、锝-甲氧基异丁基异腈（Tc-MIBI）双期平面闪烁显像及Tc-MIBI SPECT/CT成像在原发性甲状旁腺功能亢进症（PHPT）诊断中的效能。我们对2019年1月至2022年12月期间就诊于吉林大学中日联谊医院核医学科的32例PHPT患者进行了回顾性分析。所有患者在手术前两个月内均接受了C-胆碱PET/CT、颈部超声、Tc-MIBI双期平面闪烁显像及Tc-MIBI SPECT/CT检查。采用术后病理及随访结果比较各成像检查的敏感性、特异性、阳性预测值及阴性预测值。使用ROC曲线分析进一步分析诊断效能。还研究了影响Tc-MIBI成像的因素。32例患者共切除35个病灶。C-胆碱PET/CT、颈部超声、Tc-MIBI双期平面闪烁显像及Tc-MIBI SPECT/CT的诊断敏感性分别为88.2%、52.9%、58.8%和67.6%。特异性分别为96.8%、95.7%、96.8%和95.7%。阳性预测值分别为90.9%、81.8%、86.9%和85.2%，阴性预测值分别为95.7%、84.9%、86.7%和89.1%。ROC曲线下面积（AUC）分别为0.925、0.743、0.778和0.817。其中，C-胆碱PET/CT的敏感性和AUC高于其他成像检查（p<0.05），而特异性、阳性预测值和阴性预测值相似（p>0.05）。Tc-MIBI SPECT/CT成像阳性组的病灶直径明显大于阴性组（P<0.05），而术前血钙和甲状旁腺激素（PTH）无统计学差异（P>0.05）。与颈部超声、Tc-MIBI双期平面闪烁显像及Tc-MIBI SPECT/CT相比，C-胆碱PET/CT对PHPT显示出更高的术前诊断效能。病灶大小可能是影响Tc-MIBI成像敏感性的主要因素。
