THE IMPACT OF SPECT/CT HYBRID IMAGING ON ENHANCING DIAGNOSTIC ACCURACY OF PARATHYROID ADENOMA USING 99MTC-MIBI SCAN IN NUCLEAR MEDICINE DEPARTMENT OF KOSOVO

Abstract

Aim: The aim of this study was to compare the images obtained from conventional planar gamma camera and hybrid SPECT/CT triple head detectors, both present in our department and to justify the diagnostic accuracy of planar and hybrid images performing the parathyroid scintigraphy. The parathyroid scintigraphy was performed, using 99mTc-MIBI (technetium- 99m methoxyisobutylisonitrile) radiopharmaceutical. The planar scintigraphy is common procedure in most countries, but the localization of the parathyroid adenoma sometimes makes a difficult task for the surgeons. The presence of SPECT/CT with triple detectors, increased the quality and efficacy of diagnostic results, in localization of parathyroid adenoma in the neck area, especially the ectopic glands in the upper thorax. Methods: The planar scintigraphy and SPECT/CT images were performed in 42 patients that were referred in our department from March 2024 until January 2025. The initial diagnosis was primary hyperparathyroidism. Dual phase planar scintigraphy was performed at 15, 60, 90 and 120 minutes after the injection of 99mTc-MIBI radiopharmaceutical. In the same patients SPECT/CT images were obtained 160 minutes after injection of the same 99mTc-MIBI radiopharmaceutical. Results: The group of 42 patients were undergo the both modalities: planar scintigraphy dual phase and hybrid SPECT/CT with three detectors. SPECT /CT showed higher result and imaging clarity of adenoma lesions comparing with planar scintigraphy alone with sensitivity 98.0% vs. 89.7% and specificity 88.2% vs. 77.1 %. Conclusion: Hybrid SPECT/CT compare with planar scintigraphy showed a high diagnostic precision in localization of the parathyroid adenoma. It was a very successful in identifying the ectopic parathyroid gland especially located in mediastinum and successful in diminishing the thyroid normal gland from parathyroid adenoma. These findings support the importance of investment in hybrid SPECT/CT where PET/CT was not available. Hybrid technology with SPECT (Single Photon Emission Computed Tomography) fused with CT (computed tomography), plays a huge role not only in anatomical and functional assessment of parathyroid adenoma, but also it plays an important role in cases when reoperation is needed.