Tc-MIBI SPECT/CT SCINTIGRAPHY AND ULTRASOUND OF THE ANTERIOR NECK REGION IN DIAGNOSING PARATHYROID GLAND PATHOLOGY IN PATIENTS WITH THYROID NODULES/[.sup.99m]Tc-MIBI SPECT/CT SCINTIGRAFIJAI ULTRAZVUK PREDNJE VRATNE REGIJE U DIJAGNOSTICI BOLESTI PARATIREOIDNIH ZLIJEZDA KOD BOLESNIKA S NODOZNIM PROMJENAMA STITNJACE

• Published in: Acta clinica Croatica (Tisak) Vol. 60; no. 3; p. 423
• Main Authors: Nenadic, Vedrana Gladic, Markos, Ines Sisko, Punda, Marija, Blazekovic, Ivan, Franceschi, Maja, Frobe, Ana, Jukic, Tomislav
• Format: Journal Article
• Language: English
• Published: Klinicki bolnicki centar Sestre milosrdnice 01-09-2021
• Subjects: Biopsy, Needle; Diagnosis; Health aspects; Hyperparathyroidism; Physiological aspects; Radioisotope scanning; SPECT imaging; Thyroid diseases; Croatia
• ISSN: 0353-9466
• DOI: 10.20471/acc.2021.60.03.12

Parathyroid scintigraphy with [.sup.99m]Tc-MIBI is an imaging technique used in nuclear medicine and performed in patients with suspected hyperparathyroidism (HPT). The objective of this study was to evaluate the role of this technique in patients who, along with suspected HPT, also have thyroid nodules. Retrospective analysis included a period of 8 years (2006-2013). The study included 91 patients with clinical or laboratory suspected HPT. Pathologic changes in parathyroid glands were demonstrated in 47 (70%) of 67 patients with positive scintigraphy. Pathologic changes in parathyroid glands were not evident in the remaining 20 (30%) patients. Out of nine patients with negative scintigraphy results but with suspected enlargement of the parathyroid gland examined by ultrasound, eight (89%) patients did not show pathologic changes in the parathyroid gland, whereas one (11%) patient had evident changes. Eight (54%) of 15 patients with suspected scintigraphy had positive ultrasound findings, as well as fine needle aspiration cytology (FNAC) findings with parathyroid hormone (PTH) determination in the aspirate. Seven (46%) patients had negative FNAC findings and PTH in the aspirate. The study showed scintigraphy to have high sensitivity (98%) in detecting patients with pathologic changes in the parathyroid glands. In patients with suspected HPT, scintigraphy needs to be combined with FNAC and PTH determination in the aspirate due to its low specificity of 28%. Key words: [.sup.99m]Tc-MIBI, SPECT/CT; Hyperparathyroidism; Parathyroid hormone; Fine needle aspiration Scintigrafija paratireoidnih zlijezda 99mTc-MIBTjem je slikovna metoda nuklearne medicine, a provodi se kod bolesnika sa sumnjom na hiperparatireoidizam (HPT). Cilj istrazivanja bio je procijeniti vaznost upotrebe ove metode kod bolesnika koji uza sumnju na HPT imaju i nodozne promjene stitnjace. Retrospektivna analiza obuhvatila je razdoblje od 8 godina (2006.-2013.). U studiju je bio ukljucen 91 bolesnik s klinicki ili laboratorijski sumnjivim HPT. Od 67 scintigrafski pozitivnih bolesnika, patoloski promijenjena paratireoidna zlijezda dokazana je u njih 47 (70%). U preostalih 20 (30%) bolesnika patoloski promijenjena paratireoidna zlijezda nije dokazana. Od 9 bolesnika s negativnim nalazom scintigrafije, a UZV suspektnom povecanom paratireoidnom zlijezdom, patoloski promijenjena paratireoidna zlijezda nije dokazana u njih 8 (89%), a dokazana je u jednog (11%) bolesnika. Od 15 scintigrafski dvojbenih bolesnika, njih 8 (54%) je imalo pozitivan nalaz UZV i citoloske punkcije uz odredivanje PTH u punktatu. U 7 (46%) bolesnika nalaz punkcije i PTH u punktatu bio je negativan. Istrazivanje potvrduje da scintigrafija ima visoku osjetljivost za otkrivanje bolesnika s patoloski promijenjenim paratireoidnim zlijezdama (98%). Zbog niske specificnosti (28%) scintigrafiju treba nadopuniti punkcijom uz odredivanje PTH u punktatu u bolesnika sa suspektnim HPT. Kljucne rijeci: 99mTc-MIBI, SPECT/CT; Hiperparatireoidizam; Paratireoidni hormon; Punkcija