Preoperative evaluation of hyperparathyroidism: the role of dual-phase parathyroid scintigraphy and ultrasound imaging

Sükan, Aysun; Reyhan, Mehmet; Aydın, Mehmet; Yapar, Alı Fuat; Sert, Yasar; Canpolat, Tuba; Aktaş, Ayşe

doi:10.1007/s12149-007-0086-z

Cited by 114 publications

(63 citation statements)

References 43 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, a parathyroid adenoma and hyperplasia lesions show high signal-to-background ratio on the delayed phase of 99m Tc-MIBI scintigraphy. The current diagnostic choice for parathyroid adenoma and hyperplasia is a combination of 99m Tc-MIBI scintigraphy and US to localize parathyroid pathology [10]. In recent years, 99m Tc-MIBI SPECT/CT is used for the detecnodules in the neck was indicated despite of having true ectopic lesion in the mediastinum in 3 patients), and 4 with false-demonstration of the level of the glands.…”

Section: Discussionmentioning

confidence: 99%

“…However, parathyroid US is dependent on the experience of the operator [8] and has a suboptimal detection rate for multinodular thyroid disease and silent areas, such as the mediastinum, tracheoesophageal groove, and retroesophageal region [9]. Therefore, the practical choice for localization analysis in pHPT is a combination of 99m Tc-MIBI scintigraphy and US [10]. In recent years, 99m Tc-MIBI was conducted with a 4cm collar incision in the center of the neck.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Strategy of operative treatment of hyperparathyroidism using US scan and <sup>99m</sup>Tc-MIBI SPECT/CT

et al. 2014

View full text Add to dashboard Cite

Primary hyPerParathyroidism (pHPT) is a disease for which the diagnosis and treatment have become relatively straightforward. The criteria for diagnosis have become standardized with either elevated blood calcium levels, the presence of kidney stones, or decreased bone densitometry. The primary causes of pHPT are classically said to be 80%-85% due to adenoma, 10% -15% due to hyperplasia, and ~1% due to carcinoma, respectively. Majority of responsible lesion of pHPT is, thus, a single adenoma. The standard of care of pHPT is a surgical excision of the responsible lesion(s). Therefore, accurate localiza- abstract. We evaluated the efficacy of technetium-sestamibi ( 99m Tc-MIBI) SPECT/CT for planning parathyroidectomy in cases with primary hyperparathyroidism (pHPT), comparing with planar scintigraphy and ultrasound (US), in an aim to establish the proper surgical strategy according to the preoperative imaging studies. A retrospective review of consecutive 75 pHPT patients who had been operated on was conducted. The results of preoperative imaging modalities and the operative finding were analyzed. Seven cases were found to have multiple hyperplastic glands, and no responsible gland was found in three cases. Four cases underwent only US scan for preoperative imaging. Remaining 61 cases were found to have single adenoma, and were included in the evaluation of localization imaging. US scan, 99m Tc-MIBI planar scan and 99m Tc-MIBI SPECT/CT showed accurate localization in 77.0% (47/61), 75.4% (46/61) and 88.5% (46/52) of the evaluable cases, respectively. US and 99m Tc-MIBI planar scan demonstrated consistent result in 42 cases (68.9%), and those cases showed accurate localization in 90.5% (38/42). When both US and 99m Tc-MIBI SPECT/CT was consistent, all 37 lesions had been correctly indicated. No clinico-pathological features were suggested to influence in demonstrating the localization, other than only 99m Tc-MIBI SPECT/CT exhibited 100% sensitivity in ectopic glands. Combination of US and 99m Tc-MIBI SPECT/CT certainly contributes to the planning of minimally invasive operation in cases with pHPT by indicating correct localization of single adenoma.Key words: Primary hyperparathyroidism, Technetium-sestamibi ( 99m Tc-MIBI), SPECT/CT tion analysis is important.The imaging techniques that have been used to identify the location of responsible lesion(s) are technetium-thallium subtraction scan, technetium-sestamibi ( 99m Tc-MIBI) scan, ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT) [1], venous sampling of parathyroid hormone, and angiography. To date, the best results have been found using either US or technetium imaging.The sensitivity of US for detecting a single parathyroid adenoma was 57 to 87 % [2][3][4][5][6][7]. However, parathyroid US is dependent on the experience of the operator [8] and has a suboptimal detection rate for multinodular thyroid disease and silent areas, such as the mediastinum, tracheoesophageal groove, and retroesophageal region [9]. Therefore, the practical choic...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Strategy of operative treatment of hyperparathyroidism using US scan and <sup>99m</sup>Tc-MIBI SPECT/CT

et al. 2014

View full text Add to dashboard Cite

show abstract

“…It is effective in identifying parathyroid disease although its reported sensitivity varies widely from 42% to 96%. 4,10,[15][16][17][18][19][20][21] Ultrasonography is well recognised as being 'operator dependent' and the accuracy of parathyroid ultrasonography has been shown to be affected by operator experience. 4,5,17 A dedicated, experienced parathyroid ultrasonographer optimises preoperative parathyroid localisation whereas multiple ultrasonographers of varying experience performing less parathyroid ultrasonography may compromise parathyroid localisation.…”

Section: Discussionmentioning

confidence: 99%

The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

Aspinall

Nicholson

et al. 2012

annals

View full text Add to dashboard Cite

INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit. METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT). RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS). CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

show abstract

“…The most commonly used imaging techniques for the preoperative localization of parathyroid and thyroid adenomas are technetium-99m sestamibi ( 99m Tc-MI-BI) scintigraphy and ultrasonography of the neck (6).…”

Section: Introductionmentioning

confidence: 99%

The key role of 99mTc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report

Pan

Luo

et al. 2015

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

SUMMARYThe concomitant occurrence of primary hyperparathyroidism (PHPT) due to parathyroid adenoma and papillary thyroid carcinoma (PTC) is not common. The co-occurrence of parathyroid tumors and thyroid diseases can lead to misdiagnosis owing to mutual interference of imaging in the early period of disease. The most commonly used imaging techniques for the preoperative localization of parathyroid and thyroid adenomas are technetium-99m sestamibi ( 99m Tc-MIBI) scintigraphy and ultrasonography of the neck. Recently, 99m Tc-MIBI single-photon emission computed tomography associated with computed tomography scintigraphy (SPECT/CT) has been used to detect PHPT, and its diagnostic value is being evaluated. Herein, we report a patient with an unusual co-occurrence of parathyroid adenoma and multiple thyroid diseases, including papillary thyroid carcinoma, thyroid adenoma and lymphocytic thyroiditis, which were localized with 99m Tc-MIBI SPECT/CT and confirmed surgically. We suggest that 99m Tc-MIBI SPECT/CT can play an important role in the diagnosis of parathyroid and thyroid lesions. Arch Endocrinol Metab. 2015;59(3):265-9

show abstract

Preoperative evaluation of hyperparathyroidism: the role of dual-phase parathyroid scintigraphy and ultrasound imaging

Cited by 114 publications

References 43 publications

Strategy of operative treatment of hyperparathyroidism using US scan and <sup>99m</sup>Tc-MIBI SPECT/CT

Strategy of operative treatment of hyperparathyroidism using US scan and <sup>99m</sup>Tc-MIBI SPECT/CT

The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

The key role of 99mTc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report

Contact Info

Product

Resources

About