The role of 99mTc-MIBI SPECT/low dose CT with 3D subtraction in patients with secondary hyperparathyroidism due to chronic kidney disease
Abstract
Objective: To assess the incidence of parathyroid glands hyperplasia or adenoma in patients with various stages of chronic renal insufficiency using 99mTc-methoxyisobutylisonitrile (MIBI) SPECT and 3D subtraction technique with 99mTc-pertechnetate (Tc). Subjects and methods: 61 patients underwent hybrid SPECT with low-dose CT of the parathyroid glands and thyroid SPECT scintigraphy. 36 patients were with chronic kidney disease (CKD) without renal failure (RF) and 25 patients undergoing peritoneal dialysis or hemodialysis.
In each patient, two SPECT studies were performed - an early and a late one with low dose CT with MIBI injection. Additional SPECT was performed on another day with Tc.
Results: From all 61 patients, 40/61(66%) findings were positive, 7/61(12%) findings were inconclusive and 14/61(23%) findings were negative. Solitary lesions were detected in 22 patients.
More than one lesion was found in 18 patients. Conclusion: The incidence of secondary hyperparathyroidism was detected in 40/61 patients (66%) with chronic kidney disease using scintigraphy and 16 patients (40%) from them underwent surgery.
MIBI SPECT/low dose CT with 3D dual - tracer subtraction (MIBI-Tc) method is an effective tool for preoperative detection of the parathyroid glands hyperplasia or adenoma.