Diagnostic performance of planar scintigraphy using ⁹⁹mTc-MIBI in patients with secondary hyperparathyroidism: a meta-analysis.

Carmelo Caldarella, Giorgio Treglia, Alfredo Pontecorvi, Alessandro Giordano

Department of Bioimaging and Radiological Sciences, Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168 Rome, Italy. carmelocaldarella@yahoo.it

Annals of nuclear medicine 2012 Dec

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Parathyroid scintigraphy using (99m)Tc-MIBI is not currently considered a valuable diagnostic tool for the localization of involved glands in patients with secondary hyperparathyroidism (SHPT). However, published data about its diagnostic accuracy are discordant and a meta-analysis about this topic is still lacking. The aim of our study is to meta-analyze the published data about the diagnostic performance of (99m)Tc-MIBI parathyroid scintigraphy in patients with SHPT. A comprehensive computer literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through September 2011 and regarding the diagnostic accuracy of (99m)Tc-MIBI parathyroid scintigraphy in patients with SHPT was carried out. Only articles in English language in which at least 10 patients with SHPT underwent planar (99m)Tc-MIBI parathyroid scintigraphy were selected. Pooled sensitivity, pooled specificity and area under the ROC curve on a per lesion-based analysis were calculated to measure the diagnostic accuracy of (99m)Tc-MIBI parathyroid scintigraphy in SHPT patients. Twenty-four studies comprising 471 patients were included in this meta-analysis. The pooled sensitivity and specificity of (99m)Tc-MIBI parathyroid scintigraphy in detecting hyperplastic glands in SHPT patients were 58 % [95 % confidence interval (95 % CI) 52-65 %] and 93 % (95 % CI 85-100 %), respectively, on a per lesion-based analysis. Area under ROC curve was 0.75. In patients with SHPT and diffuse or nodular hyperplasia, planar parathyroid scintigraphy using (99m)Tc-MIBI has demonstrated an inadequate diagnostic accuracy. Therefore, it should not be considered as a first-line diagnostic imaging method in the pre-surgical detection of hyperplastic parathyroid glands.

Citation

Carmelo Caldarella, Giorgio Treglia, Alfredo Pontecorvi, Alessandro Giordano. Diagnostic performance of planar scintigraphy using ⁹⁹mTc-MIBI in patients with secondary hyperparathyroidism: a meta-analysis. Annals of nuclear medicine. 2012 Dec;26(10):794-803