EFFICACY OF DUAL PHASE PLANNER 99MTC-SESTAMIBI PARATHYROID SCAN IN IDENTIFYING PARATHYROID ADENOMA AS A CAUSE OF HYPERPARATHYROIDISM; A SINGLE CENTER EXPERIENCE

Abdullah Al-Zreiqat*, Eslam Jabali, Ola Attieh, Hamzeh Aladwan, Anas Zboun, Ala’a Al- Zub’i, Rania Al-Asa'ad, Tahani Alhowarat, Khaled Alkawaldeh

ABSTRACT

AIM: The aim of this study was to review the experience of the Nuclear Medicine Department at Royal Medical Services (RMS) in assessing the efficacy of 99mTc-sestamibi scans in identifying parathyroid adenoma as a cause of hyperparathyroidism. PATIENTS AND METHODS: This is a retrospective study for 120 patients who underwent both 99mTc-sestamibi parathyroid scans followed by elective parathyroidectomy from 2017–2020 at King Hussein Medical Centre (KHMC). Visual analysis of early (10–20 minutes) and delayed (2–3 hours) images was done, and any focally progressive tracer accumulation on the early and delayed images was reported as positive for parathyroid adenoma. Histopathology reports were reviewed for final diagnosis. RESULTS: One hundred and twenty patients underwent sestamibi scans during the period of the study with a mean age of 48 years (range 27–82 years). One hundred and nine had an elective parathyroidectomy (102 patients with positive sestamibi scan findings and 7 patients with a negative sestamibi scan), while 99 patients had a parathyroid adenoma in postoperative histopathology reports, with 96.9% sensitivity, 71.4% specificity, 94% positive predictive value, 83.3% negative predictive value, and 92.5% accuracy. CONCLUSION: Dual-phase planner 99mTc-sestamibi parathyroid scintigraphy has proved its efficiency as a trustable diagnostic tool in identifying parathyroid adenoma as a cause of hyperparathyroidism, with highly concordant results found for surgery at KHMC.

Keywords: Hyperparathyroidism, 99mTc-sestamibi, Parathyroid adenoma, Dual-phase imaging.