Added value of ultrasonography and Tc-99m MIBI SPECT/CT combined protocol in preoperative evaluation of parathyroid adenoma

Purpose: Evaluating the diagnostic performance of combined protocol of ultrasonography and Tc-99 m MIBI SPECT/CT in preoperative depiction and localization of parathyroid adenoma. Methods and materials: 60 patients were enrolled in this retrospective study who had primary hyperparathyroidism and parathyroidectomy for parathyroid adenoma, all of them underwent ultrasonography examination of parathyroid gland and MIBI SPECT/CT for exact pre-operative localization of parathyroid adenoma, surgical and pathological results were used as standard reference then sensitivity, specificity and accuracy for each modalility and for combined protocol of both modalities was calculated. Results: The sensitivity, specificity and accuracy were highest with combined protocol of ultrasonography and MIBI-SPECT/CT (87 %), (71 %) and (85 %) respectively and lowest sensitivity, specificity and accuracy with ultrasonography alone (76 %), (63 %) and (73 %) respectively while (83 %), (66 %) and (80 %) with MIBI-SPECT/CT alone. Conclusion: Concomitant use of ultrasonography and MIBI SPECT/CT is highly recommended for better preoperative depiction and localization of parathyroid adenoma.