SPECT/CT for secondary hyperparathyroidism

Objectives: To explore the diagnostic value of 99mTc-Sestamibi multiple-phase static planar imaging and SPECT/CT in secondary hyperparathyroidism. Methods: This was a retrospective analysis of 40 cases of clinically diagnosed secondary hyperparathyroidism with multiple-phase static planar imaging, 15 min SPECT/CT fusion imaging, and ultrasonography. All cases were confirmed by pathological examination. Detection of lesions was compared between dual-phase and multi-temporal planar imaging, the detection rate of lesions using planar imaging, SPECT/CT, and ultrasonography was analyzed, and the characteristics of parathyroid tissue calcification detected by SPECT/CT were summarized. Results: The number of lesions detected was 69 by multi-temporal planar imaging and 57 by dual-phase imaging; scans at both 60 min and 90 min detected 12 lesions. SPECT/CT detected more lesions than planar imaging and ultrasonography; the sensitivities were 93.1%, 47.9%, and 70.1%, the accuracy was 88.7%, 47.6%, and 69.7%, respectively, and the specificity was 100%. Eighteen of 40 patients had parathyroid tissue calcification, 134 lesions in 32 patients exhibited calcification, and 90.6% of the 32 lesions were 99mTc-Sestamibi positive. Conclusions: Multi-temporal planar imaging detected more lesions than dual-phase imaging. SPECT/CT plays an important role in the qualitative and quantitative evaluation and positioning of secondary hyperparathyroidism lesions.