[Analysis of influencing factors for preoperative negative 99mTc-MIBI imaging in patients with single parathyroid tumor].
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
Objective:To explore the influencing factors of negative preoperative technetium-99m methoxyisobutyl isonitrile（99mTc-MIBI） imaging in patients with single parathyroid adenoma. Methods:A total of 378 patients with single parathyroid tumors who underwent primary open cervical surgery were retrospectively enrolled. According to the results of preoperative 99mTc-MIBI imaging results, the patients were divided into the 99mTc-MIBI negative group and positive group. The baseline data, laboratory indicators, imaging findings and pathological characteristics were compared between the two groups to analyze the correlative and independent influencing factors of preoperative negative 99mTc-MIBI results. ROC curve analysis was performed to evaluate the predictive value of preoperative serum calcium and tumor volume for 99mTc-MIBI negativity. Results:Of the 378 enrolled patients, postoperative pathology confirmed 372 cases（98.4%） of parathyroid adenoma and 6 cases（1.6%） of atypical parathyroid tumor. Among them, 70 patients（18.5%） presented with negative preoperative 99mTc-MIBI scintigraphy results. Compared with the 99mTc-MIBI positive group, the negative group had a milder elevation of preoperative serum calcium, lower alkaline phosphatase（ALP） levels, a lower proportion of tumor cystic degeneration and smaller tumor volume, with all differences being statistically significant（P<0.05）. Multivariate Logistic regression analysis demonstrated that mild preoperative hypercalcemia and small tumor volume were independent risk factors for 99mTc-MIBI negativity. ROC curve analysis showed that the area under the curve（AUC） of preoperative serum calcium for predicting99mTc-MIBI negativity was 0.612（95%CI 0.538-0.687, P<0.01）, with an optimal cut-off value of 2.59 mmol/L. The AUC of tumor volume was 0.750（95%CI 0.692-0.808, P<0.01）, and the optimal cut-off value was 563 mm³. The median follow-up duration was 39.5 months, and the biochemical cure rate was 99.7%. Conclusion:In patients with single parathyroid tumors, the correlated factors for negative preoperative 99mTc-MIBI imaging included mild elevation of preoperative serum calcium, low ALP level, absence of tumor cystic degeneration and small tumor volume. Among these factors, mild preoperative hypercalcemia and small tumor volume were independent risk factors for negative 99mTc-MIBI imaging.