Detecting Synchronous Parathyroid Adenoma and False-Positive Findings on Technetium-99m MIBI Single Photon-Emission Computed Tomography/Computed Tomography

Lee, Ji Young; Song, Hee-Sung; Choi, Jae Hyuck; Hyun, Chang Lim; Lee, Sang Ah; Choi, Joon-Hyouk; Lee, Seokjae

doi:10.3390/diagnostics9020057

Cited by 3 publications

(2 citation statements)

References 21 publications

(26 reference statements)

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“…Pre-operatory MIBI SPECT/CT confirmed a late uptake on two focal areas at the level of the left thyroid lobe, but the post-surgery histological report showed that only one was a parathyroid adenoma and the other was a thyroid hyperplasia. Notably, pre-operatory 99m-Tc MIBI planar scintigraphy was not relevant, only showing positive at SPECT/CT; thus, we may conclude that false positive images due to synchronous concurrent thyroid conditions may be detected even with regard to advanced imaging modalities [68].…”

Section: Ectopic Thyroid Tissuementioning

confidence: 73%

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Carsote,

Stanciu,

Popa

et al. 2023

Medicina

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Diagnosis of primary hyperparathyroidism (PHP) is based on blood assessments in terms of synchronous high calcium and PTH (parathormone), but further management, particularly parathyroid surgery that provides the disease cure in 95–99% of cases, requires an adequate localisation of the parathyroid tumour/tumours as the originating source, with ultrasound and 99m-Technetium (99m-Tc) sestamibi scintigraphy being the most widely used. We aimed to introduce an adult female case diagnosed with PHP displaying unexpected intra-operatory findings (ectopic thyroid tissue) in relation to concordant pre-operatory imaging modalities (ultrasound + dual-phase 99m-Tc pertechnetate and sestamibi scintigraphy + computed tomography) that indicated bilateral inferior parathyroid tumours. A sudden drop in PTH following the removal of the first tumour was the clue for performing an extemporaneous exam for the second mass that turned out to be non-malignant ectopic thyroid tissue. We overviewed some major aspects starting from this case in point: the potential pitfalls of pre-operatory imaging in PHP; the concordance/discordance of pre-parathyroidectomy localisation modalities; the need of using an additional intra-operatory procedure; and the clues of providing a distinction between pathological parathyroids and thyroid tissue. This was a case of adult PHP, whereas triple localisation methods were used before parathyroidectomy, showing concordant results; however, the second parathyroid adenoma was a false positive image and an ectopic thyroid tissue was confirmed. The pre-operatory index of suspicion was non-existent in this patient. Hybrid imaging modalities are most probably required if both thyroid and parathyroid anomalies are suspected, but, essentially, awareness of the potential pitfalls is mandatory from the endocrine and surgical perspectives. Current gaps in imaging knowledge to guide us in this area are expected to be solved by the significant progress in functional imaging modalities. However, the act of surgery, including the decision of a PTH assay or extemporaneous exam (as seen in our case), represents the key to a successful removal procedure. Moreover, many parathyroid surgeons may currently perform 4-gland exploration routinely, precisely to avoid the shortcomings of preoperative localisation.

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Section: Ectopic Thyroid Tissuementioning

confidence: 73%

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Carsote,

Stanciu,

Popa

et al. 2023

Medicina

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“…With the continuous development of imaging technology, the diagnostic efficiency of SPECT imaging for benign and malignant thyroid lesions is gradually improved. Among them, 99m TcO 4 -SPECT imaging can directly reflect the anatomical and functional information of the thyroid gland, with simple operation and strong reproducibility, which is of great significance for the early diagnosis and prognosis of thyroid diseases [8].…”

Section: Introductionmentioning

confidence: 99%

Single-Photon Emission Computed Tomography Image-Assisted Diagnosis of Thyroid Diseases under Convolutional Network Neural Algorithm

Chen

Gong

et al. 2021

Scientific Programming

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The aim of this study was to investigate the value of single-photon emission computed tomography (SPECT) based on the convolutional neural network (CNN) algorithm in thyroid diseases. Thirty-five patients with thyroid disease from the hospital were selected as the observation group, and another 35 healthy volunteers were selected as the control group. The constructed model of SPECT based on the CNN algorithm was compared with the backpropagation neural network (BPNN) algorithm, which was then applied to the SPECT of 35 patients with thyroid disease. It turned out that as the number of iterations increased, the parameter training of CNN was gradually sufficient, the network model was continuously optimized, and the accuracy gradually increased. From the data results, the Dice value of the proposed CNN algorithm was higher than that of the BPNN algorithm and the segmentation effect was relatively good. The visual index of the thyroid/neck of the observation group (2.68 ± 1.32) was remarkably inferior to that of the control group (12.347.54) ( P < 0.05 ). The visual index of the thyroid/submandibular gland in the observation group (1.02 ± 0.41) was remarkably inferior to that of the control group (8.89 ± 4.86) ( P < 0.05 ). The visual index of the thyroid/parotid gland in the observation group (1.04 ± 0.58) was remarkably inferior to that of the control group (8.53 ± 4.25) ( P < 0.05 ). In addition, 99mTcO4-SPECT had a sensitivity of 95.2%, a specificity of 90.3%, and an accuracy of 91.5% in the diagnosis of thyroid diseases. The area under the curve of the receiver operating characteristic curve for 99mTcO4-SPECT diagnosis of thyroid disease is 0.958, and the 95% confidence interval is 0.834∼1. In summary, the SPECT based on the CNN algorithm proposed in this study has a good segmentation effect and can accurately locate the anatomical information of thyroid diseases, which can replace the traditional diagnostic methods for the diagnosis of thyroid diseases.

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Application of magnetic targeted fluorescence/magnetic resonance dual-modal imaging in cancer diagnosis

Nan

Zuo

et al. 2023

J Nanopart Res

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Detecting Synchronous Parathyroid Adenoma and False-Positive Findings on Technetium-99m MIBI Single Photon-Emission Computed Tomography/Computed Tomography

Cited by 3 publications

References 21 publications

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Single-Photon Emission Computed Tomography Image-Assisted Diagnosis of Thyroid Diseases under Convolutional Network Neural Algorithm

Application of magnetic targeted fluorescence/magnetic resonance dual-modal imaging in cancer diagnosis

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