Keywords
Scintigraphy
99mTc-Sestamibi
Parathyroid Glands
Calcium
Phosphorus
How to Cite
Abstract
Background: The calcium/phosphorus ratio in patients with primary hyperparathyroidism had shown to be an important marker, with good performance for the diagnostic of this pathology, whilst the parathyroid scintigraphy with Tc99m-MIBI is one of the most widely used methods for the localization of the hyperfunctioning parathyroid tissue that is causing it. However, there are not studies that evaluate the value of the calcium/phosphorus ratio in the decisions-making of sending a patient to the performing of a scintigraphy.
Purpose: To identify the best cut-off point of the serum calcium/phosphorus ratio for the performance of a Tc99m-MIBI parathyroid scintigraphy in patients with primary hyperparathyroidism.
Methodology: Observational cross-sectional study. The results of the calcium/phosphorus ratio and Tc99m-MIBI parathyroid scintigraphy were analyzed in patients from the nuclear medicine department in two centers in Bogotá, Colombia during 2017 – 2022.
Results: 263 patients were analyzed of whom 240 (91%) were women. 150 had negative results in the parathyroid scintigraphy and 113 had positive results. The calcium/phosphorus ratio in the patients with negative scintigraphy was 3.21 ± 0.90 and 4.03 ± 0.84 in the positive group. The ROC analysis showed that 3.4 was the best cut-off point with a specificity of 74% and a sensitivity of 77%. The 96% of patients with a ratio under 2.68 had negative results.
Conclusions: The patients with primary hyperparathyroidism and a calcium/phosphorus ratio greater than 3.4 had a probability of a positive scintigraphy in 77% of the cases and a 26% false-positive’s possibility. The 96% of the patients in which the ratio was less than 2.68 had a negative scintigraphy.
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