99mTc-MIBI SPECT in primary hyperparathyroidism. Influence of concomitant vitamin D deficiency for visualization of parathyroid adenomas.
AIM of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of (99m)Tc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT).


METHODS
Between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a (99m)Tc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase (99m)Tc-MIBI protocol with SPECT were compared with histopathology.


RESULTS
In 54 pts with normal vitamin D values late SPECT images identified more lesions (n=51, sensitivity 91%) than early planar (n=45, sensitivity 82%) or late planar images (n=50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n=13, sensitivity 72%) than early planar (n=10, sensitivity 56%) or late planar images (n=10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a (99m)Tc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p=0.1625; late planar: p=0.0039; (99m)Tc-MIBI SPECT: p=0.1180.


CONCLUSIONS
The likelihood of a pathological (99m)Tc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency.
Schmidt
M
M
Department of Nuclear Medicine, University of Cologne, Cologne, Germany. Matthias.Schmidt@uni-koeln.de
Thoma
N
N
Dietlein
M
M
Moka
D
D
Eschner
W
W
Faust
M
M
Schröder
W
W
von Hülst-Schlabrendorff
M
M
Ehses
W
W
Schicha
H
H
D000236:Adenoma / Q000000981:diagnostic imaging*; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D009929:Organ Size; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography; D014808:Vitamin D Deficiency / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology
D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi