Clinical utility of ultrasound and 99mTc sestamibi SPECT/CT for preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism

Patel, Chirag; Salahudeen, H.M.; Lansdown, Mark; Scarsbrook, Andrew

doi:10.1016/j.crad.2009.12.005

Cited by 169 publications

(163 citation statements)

References 26 publications

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“…Previous studies have shown a clear benefit of SPECT/CT, with an increased sensitivity and accuracy over ultrasonogram or planar scans alone, and especially in patients with concomitant nodular goiter [16,17]. However, only one study has Fig.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Hwang

Rhee

Yun

et al. 2016

Nucl Med Mol Imaging

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Purpose Parathyroid adenoma detection with dual-phase 99m Tc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection. We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients. Methods Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CT was performed immediately after delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention. Results In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CT-HU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention. Conclusion AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.

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Section: Discussionmentioning

confidence: 99%

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Hwang

Rhee

Yun

et al. 2016

Nucl Med Mol Imaging

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“…En un estudio de un grupo quirúrgico, publicado recientemente, se observó que los endocrinólo-gos tenían menos probabilidades de derivar al cirujano a los pacientes con cintigrama paratiroideo negativo (OR = 0,36; IC 95%: 0,18-0,73), así como los cirujanos estaban menos inclinados a realizar paratiroidectomía en estos pacientes (OR = 0,32; IC 95%: 0,11-0,91) 12 . En estos casos, el cintigrama paratiroideo y la ecotomografía pueden ser complementarios, sobre todo para la localización de glándulas ectópicas retroesofágicas o intratiroideas 23,24 . También se puede considerar el uso de FDG (fluordeoxiglucosa) con técnica PET-CT (tomografía de emisión de positrones) como modalidad de imágenes de segunda línea para localización de la glándula patológica, pues disminuye los falsos negativos 25 .…”

Section: Discussionunclassified

Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario

et al. 2017

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“…This is also countered by the fact that studies have shown that experienced surgeons have a 90% -95% cure rate in patients who undergo neck exploration for the first time. A recent study has shown that sestamibi combined with ultrasound increases the accuracy of detection for parathyroid adenomas [4].…”

Section: Discussionmentioning

confidence: 99%

Large parathyroid adenoma presenting as a femoral fracture in a young male

Light¹,

Munipalle²,

Kurup³

2013

CRCM

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Clinical utility of ultrasound and 99mTc sestamibi SPECT/CT for preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism

Cited by 169 publications

References 26 publications

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario

Large parathyroid adenoma presenting as a femoral fracture in a young male

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