PURPOSE: Tc-MIBI+SPECT/CT (MIBI) in preoperative localization for patients with primary hyperparathyroidism (PHPT), and assess potential factors influencing their diagnostic utility including patient characteristics, lesion size and comorbidities. METHODS: This was a real-life, retrospective study involving 125 participants, who underwent ultrasound-guided fine needle aspiration biopsy with PTHw determined by electrochemiluminescence (Elecsys analyser) and subtraction scintigraphy together with SPECT/CT images. RESULTS: = 3.92, p = 0.048; φ = -0.18). The right inferior gland was the most frequent lesion location detected by PTHw (28.0%). PTHw correlated positively with serum PTH (r=0.29), PTHw-to-serum PTH ratio (r=0.84), total calcium (r=0.27), ionized calcium (r=0.31) and alkaline phosphatase (r=0.31), and inversely with phosphate (r = -0.22) and vitamin D (r= -0.20). CONCLUSION: Tc-MIBI with SPECT/CT, in the preoperative PHPT imaging diagnostics, particularly when one modality yields negative or inconclusive results. Additionally, our results highlight the need for individualized imaging strategies based on specific patient profiles. Larger prospective studies with histopathological verification are warranted to corroborate these observations and refine preoperative localization protocols.
Cieślewicz et al. (Wed,) studied this question.