Objective To observe the correlations of quantitative 99Tcm-methoxyisobutylisonitrile(99Tcm-MIBI)SPECT/CT imaging parameters,functional markers and disease severity of primary hyperparathyroidism(PHPT)related to parathyroid adenoma.Methods Fifty-eight patients with PHPT due to single parathyroid adenoma were retrospectively collected,clinical data including serum parathyroid hormone(PTH)levels were recorded,and quantitative 99Tcm-MIBI SPECT/CT imaging parameters were obtained.According to serum calcium level reflecting disease severity(2.55-2.80 mmol/L or＞2.80 mmol/L),the patients were categorized into type Ⅰ group(n=25)and type Ⅱ group(n=33).Quantitative metabolic parameters of lesions,i.e.standard uptake value(SUV)values(the maximum SUV[SUVmax],the mean SUV[SUVmean],the peak SUV[SUVpeak]),SUV values normalized by lean body mass(SUL,including the maximum SUL[SULmax],the mean SUL[SULmean]and the peak SUL[SULpeak]),total lesion volume(TLV)and total lesion uptake(TLU),as well as derived parameters such as lesion to background ratio(LBR)contrast to contralateral deltoid muscle and lesion density(LD)were obtained from reconstructed images and compared between groups.The area under curves(AUC)of the receiver operating characteristic(ROC)curves were used to evaluate the performance of each index and their combined logistic regression model for distinguishing the severity of PHPT.Results The serum PTH and serum calcium levels in type Ⅰ group were both significantly lower than those in type Ⅱ group(both P＜0.05).No statistically significant difference of detection rate of parathyroid adenoma with PHPT was found between 99Tcm-MIBI SPECT/CT and planar imaging(96.56％vs.91.38％,P=0.063).TLV and TLU were weakly correlated with serum PTH(rs=0.416,0.422)and serum calcium levels(rs=0.391,0.349)(all P＜0.05).TLV and TLU values in type Ⅰgroup were significantly lower than those in type Ⅱ group(both P＜0.05).The AUC of PTH,TLV and TLU for differentiating type Ⅰ and type Ⅱ PHPT related to parathyroid adenoma was 0.770,0.741 and 0.716,respectively,of the combination of all the three was 0.790,and no statistical difference was detected(Z=0.361-1.454,all P＞0.05).Conclusion 99Tcm-MIBI SPECT/CT quantitative metabolic parameters TLV and TLU could be used to evaluate the functional status of parathyroid and severity of PHPT related to parathyroid adenoma.

Objective To observe the correlations of quantitative 99Tcm-methoxyisobutylisonitrile(99Tcm-MIBI)SPECT/CT imaging parameters,functional markers and disease severity of primary hyperparathyroidism(PHPT)related to parathyroid adenoma.Methods Fifty-eight patients with PHPT due to single parathyroid adenoma were retrospectively collected,clinical data including serum parathyroid hormone(PTH)levels were recorded,and quantitative 99Tcm-MIBI SPECT/CT imaging parameters were obtained.According to serum calcium level reflecting disease severity(2.55-2.80 mmol/L or＞2.80 mmol/L),the patients were categorized into type Ⅰ group(n=25)and type Ⅱ group(n=33).Quantitative metabolic parameters of lesions,i.e.standard uptake value(SUV)values(the maximum SUV[SUVmax],the mean SUV[SUVmean],the peak SUV[SUVpeak]),SUV values normalized by lean body mass(SUL,including the maximum SUL[SULmax],the mean SUL[SULmean]and the peak SUL[SULpeak]),total lesion volume(TLV)and total lesion uptake(TLU),as well as derived parameters such as lesion to background ratio(LBR)contrast to contralateral deltoid muscle and lesion density(LD)were obtained from reconstructed images and compared between groups.The area under curves(AUC)of the receiver operating characteristic(ROC)curves were used to evaluate the performance of each index and their combined logistic regression model for distinguishing the severity of PHPT.Results The serum PTH and serum calcium levels in type Ⅰ group were both significantly lower than those in type Ⅱ group(both P＜0.05).No statistically significant difference of detection rate of parathyroid adenoma with PHPT was found between 99Tcm-MIBI SPECT/CT and planar imaging(96.56％vs.91.38％,P=0.063).TLV and TLU were weakly correlated with serum PTH(rs=0.416,0.422)and serum calcium levels(rs=0.391,0.349)(all P＜0.05).TLV and TLU values in type Ⅰgroup were significantly lower than those in type Ⅱ group(both P＜0.05).The AUC of PTH,TLV and TLU for differentiating type Ⅰ and type Ⅱ PHPT related to parathyroid adenoma was 0.770,0.741 and 0.716,respectively,of the combination of all the three was 0.790,and no statistical difference was detected(Z=0.361-1.454,all P＞0.05).Conclusion 99Tcm-MIBI SPECT/CT quantitative metabolic parameters TLV and TLU could be used to evaluate the functional status of parathyroid and severity of PHPT related to parathyroid adenoma.