Table 5.
Comparative studies evaluating performance of various imaging modalities in primary hyperparathyroidism (PHPT).
| Studies | Imaging Modality | PA | MGD | PA and/or MGD (Not Specified) |
Comments |
|---|---|---|---|---|---|
| Krol et al. [112] |
4DCT |
Patient and localisation S = 70.6% PPV = 86.1% Lateralization S = 62.7% PPV = 88.9% |
- | - | Significantly higher sensitivity of 4DCT for patient and localisation level |
| US + 99Tc MIBI SPECT/CT |
Patient and localisation S = 51.9% 67.9% Lateralization S = 44.4% PPV = 85.7% |
||||
| Patel et al. [113] | 18F-FCH PET/CT | - | - |
Patient-wise analysis S = 92% DR = 92.4% Lesion-wise analysis S = 90% Negative conventional imaging/persistent PHPT S = 84% |
FCH PET/CT scan had a higher pooled sensitivity than 4DCT in detecting patients with PHPT |
| 4DCT |
Patient-wise analysis S = 85% DR = 76.85% Lesion-wise analysis S = 79% Negative conventional imaging/persistent PHPT S = 72% |
||||
| He et al. [114] |
US | - | - | S = 100% | 99mTc-MIBI scintigraphy could increase the specificity in paediatric patients with multigland disease suspected by US. |
| 99Tc MIBI | S = 93.8% | ||||
| Christensen et al. [115] | 11C-Choline PET | - | - | S = 82% | |
| Di-SPECT | S = 87% | ||||
| Lee et al. [116] |
Choline PET-CT | - | - | 0.987 | Highest surface under the cumulative ranking curve (SUCRA) value of Choline PET-CT for localisation |
| MET PET-CT | 0.7046 | ||||
| MIBI SPECT | 0.5465 | ||||
| MIBI planar | 0.0585 | ||||
| Dual tracer | 0.3241 | ||||
| US | 0.1286 | ||||
| CT | 0.7780 | ||||
| MRI | 0.4700 | ||||
| Murugan et al. [117] |
4DCT | - | - | S = 96.7% Sp = 66.6% A = 95.2% PPV = 98.3% NPV = 50% |
|
| 4DMRI | S = 96.7% Sp = 66.6% A = 95.2% PPV = 98.31% NPV50% |
||||
| de Jong et al. [118] |
CT | A = 81% | US and CT could be considered as a first-line imaging modality in patients with PHPT considered for MIP. | ||
| US and CT | A = 50% | S = 88% | |||
| US and sestamibi | A = 62% | A = 40% | S = 65% | ||
| Whitman et al. [119] |
18F-FCH PET |
S = 0.96 | 18F-FCH PET demonstrates high localisation accuracy in patients with hyperparathyroidism. | ||
| 99mTc-sestamibi scans | S = 0.54 | ||||
| Özdemir et al. [120] |
Planar scintigraphy | S = 80.4% Sp = 42.8% PPV = 91.1% A = 75.8% |
- | - | |
| SPECT/CT | S = 80.4% Sp = 57.7% PPV = 91.1% A = 77.5% |
||||
| US | S = 88.2% Sp = 85.7% PPV = 97.8% A = 87.9% |
||||
| SPECT + US | S = 94.1% Sp = 71.4% PPV = 96% A = 91.3% |
||||
| Saerens et al. [121] |
US | S = 36/90 40% Sp = 211/221 95.5% PPV = 36/46 78.3% NPV = 211/265 79.6% |
- | - | |
| Subtraction scintigraphy | S = 24/75 32% Sp = 169/185 91.4% PPV = 24/40 60% NPV = 169/220 76.8% |
||||
| MET-PET/CT | S = 13/22 59.1% Sp = 44/46 95.7% PPV = 13/15 86.7% NPV = 44/53 83% |
||||
| 4DCT | S = 5/8 62.5% Sp = 24/25 96% PPV = 5/6 83.3% NPV = 24/27 88.9% |
||||
| Bioletto et al. [122] |
18F-FCH PET |
- | - | S = 92% PPV = 95% |
Superior performance of 18F-Fluorocholine in terms of sensitivity |
| MET-PET | S = 80% PPV = 95% |
||||
| Okudan et al. [123] |
99Tc MIBI SPECT/CT | S = 92.17% PPV = 94.64% A = 87.60% |
- | - | Tc-MIBI SPECT/CT is more accurate than ultrasound for the preoperative identification of single PAs in patients with PHPT who are candidates for MIP. |
| US | S = 75.89% PPV = 90.43% A = 70.25% |
||||
| Kairemo et al. [124] |
Dual-phase scintigraphy including SPECT/CT | S = 93% | - | - | |
| 4DCT | S = 93% | ||||
| US | S = 73% |
PA: parathyroid adenoma, MGD: multiglandular parathyroid disease, US: ultrasound, 4DCT: four-dimensional computed tomography, SPECT: single photon emission computed tomography, MRI: magnetic resonance imaging, 18F-FCH PET/CT: fluoro-choline positron emission tomography, A: accuracy, S: sensitivity, Sp: specificity, PPV: positive predictive value, NPV: negative predictive value, DR: detection rate, MIP: minimally invasive parathyroidectomy.