The feasibility of anterior 180° 99m Tc-sestamibi parathyroid SPECT/CT

Ann Nucl Med. 2021 Feb;35(2):203-210. doi: 10.1007/s12149-020-01553-9. Epub 2021 Jan 3.

Abstract

Objective: For 99mTc-sestamibi parathyroid single photon emission computed tomography/computed tomography (SPECT/CT), the traditional full-arc 360° acquisition technique has been suggested but not the theoretically low tissue-attenuated anterior 180° method. We aimed to compare the diagnostic performances and target-to-background ratios of anterior 180° and 360° SPECT/CT imaging.

Methods: Ninety-nine patients who underwent 99mTc-sestamibi scintigraphy and received a surgical-pathological diagnosis of parathyroid adenoma or hyperplasia were enrolled. The SPECT/CT reconstructed images with anterior 180° and full-arc 360° data were interpreted by two physicians using a scoring scale, and the lesions were semi-quantified using target-to-background ratios for both image sets.

Results: In total, 113 abnormal parathyroid lesions were identified on the SPECT/CT images. The agreements of interpretation between the two image sets and readers were very good (κ value: 0.83-1.00). The accuracies of summative interpretation for the anterior 180° and full-arc 360° SPECT/CT were 83.04% and 82.46%, respectively. The target-to-background ratios were significantly higher for the anterior 180° than the full-arc 360° images (P < 0.01).

Conclusions: The anterior 180° SPECT/CT technique, a time-saving method, can provide satisfactory diagnostic performance and superior lesion contrast compared with the full-arc 360° SPECT/CT technique in 99mTc-sestamibi parathyroid imaging.

Keywords: 99mTc-sestamibi; Hyperparathyroidism; Parathyroid; SPECT/CT.

MeSH terms

  • Feasibility Studies
  • Female
  • Humans
  • Hyperplasia / diagnostic imaging
  • Image Processing, Computer-Assisted
  • Male
  • Multivariate Analysis
  • Parathyroid Glands / pathology*
  • Parathyroid Neoplasms / diagnostic imaging*
  • Radionuclide Imaging
  • Radiopharmaceuticals / chemistry*
  • Single Photon Emission Computed Tomography Computed Tomography / methods*
  • Technetium Tc 99m Sestamibi / chemistry*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi