Sestamibi parathyroid imaging

McBiles, Mike; Lambert, Albert T.; Cote, Marc G.; Kim, Sun Yong

doi:10.1016/s0001-2998(95)80012-3

Cited by 152 publications

(63 citation statements)

References 26 publications

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“…However, a number of parathyroid lesions show rapid washout of MIBI and, consequently, a gain in specificity would result in a loss of sensitivity. 11,16,21 We cannot draw conclusions from the present study on this issue, because the results of the double phase technique were not interpreted blinded to the subtraction method, while the corresponding findings were not reported separately.…”

Section: Mibimentioning

confidence: 86%

The value of scintigraphy and ultrasonography in the preoperative localization of parathyroid glands in patients with primary hyperparathyroidism and concomitant thyroid disease

Alexandrides

Kouloubi²,

Vagenakis³

et al. 2006

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Parathyroid scintigraphy and high-resolution ultrasonography are frequently used as preoperative localization procedures in primary hyperparathyroidism. However, when thyroid disease coexists, their diagnostic accuracy is probably abated. DESIGN: 56 patients with primary hyperparathyroidism were prospectively evaluated with parathyroid scintigraphy (with either thallium or technetium-99m agents or both) and 44 of them were also evaluated with ultrasonography. RESULTS: 33 patients (59%) had coexistent thyroid disease. Upon operation, 48 patients were found to have a solitary parathyroid adenoma and were all cured. One patient had a carcinoma and 7 had multiglandular parathyroid disease. Regarding solitary lesions, the sensitivity of parathyroid scintigraphy with Tc-agents was 97% and thallium 78%, while that of ultrasonography was 74%. The false positive rate was 2.6%, 18% and 22%, respectively. Concomitant thyroid disease had a non-significant effect on the results of parathyroid scintigraphy and ultrasonography. The efficiency of both modalities in diagnosing multiglandular disease was low (only 3/7 patients, 43%). CONCLUSIONS: Parathyroid scintigraphy, in conjunction with Sestamibi or Tetrofosmin, constitutes the most sensitive localizing technique as regards solitary lesions. Ultrasonography is also useful in confirming scintigraphic findings, offers more precise anatomic information, and is valuable in the evaluation of concomitant thyroid disease. The complementary use of parathyroid scintigraphy and ultrasonography is beneficial and efficacious in areas with high prevalence of thyroid disease. The value of these modalities is considerably lower in multiglandular disease.

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Section: Mibimentioning

confidence: 86%

The value of scintigraphy and ultrasonography in the preoperative localization of parathyroid glands in patients with primary hyperparathyroidism and concomitant thyroid disease

Alexandrides

Kouloubi²,

Vagenakis³

et al. 2006

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“…Focused neck exploration in patients with primary hyperparathyroidism has recently replaced the traditional bilateral approach due to a decrease in operative morbidity and a shortening Planar scintigraphy has been considered the primary imaging modality for the pre-operative localization of parathyroid adenomas with pooled sensitivities of 87% for subtraction imaging and 73% for dual-phase imaging (23). The results of the present study (Group 1) revealed sensitivities of 76% on patient-based and 69% on lesion-based analysis and are within the range of the results from the dual-phase methods reported in the literature (24).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of parathyroid imaging: comparison of planar scintigraphy, spect, spect/ct and c-11 methionine pet for the detection of parathyroid adenomas and glandular hyperplasia

Öksüz

Dittmann²,

Wicke³

et al. 2010

Diagn Interv Radiol

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Sporadic primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient population, with a prevalence of one per 500 women and one per 2000 men over 40 years of age. Both increased cell proliferative activity and a decreased sensitivity of cells to secretory inhibition by calcium occur in hyperparathyroidism (1). The diagnosis of hyperparathyroidism is usually made by the demonstration of an inappropriately elevated parathyroid hormone level compared to the simultaneously measured serum calcium level (2). In 80% to 85% of patients, primary hyperparathyroidism is caused by one or more parathyroid adenomas, and in 15% to 20% of cases, it is the result of parathyroid hyperplasia. A rare cause of primary hyperparathyroidism, accounting for less than 1% of all cases, is parathyroid carcinoma. Persistent hyperparathyroidism occurs in 5% to 10% of all patients who undergo surgery for primary hyperparathyroidism, with a continuation of the pre-operative hypercalcemia in the immediate post-operative period. Hyperparathyroidism that presents after a period of more than six months of normocalcemia following surgery is called "recurrent hyperparathyroidism" and is commonly due to continuing growth of the remaining parathyroid glands (3). Secondary hyperparathyroidism is a compensatory hypertrophy of all parathyroid glands due to hypocalcemia, as occurs in renal failure or with vitamin D deficiency (4), whereas tertiary hyperparathyroidism describes the development of autonomous function of parathyroid tissue after longstanding secondary hyperparathyroidism (5-8).In most cases (80%-85%), parathyroid adenomas are found adjacent to the thyroid gland, which is the normal location for these adenomas. However, in up to 20% of cases, they are ectopically placed, e.g., in the anterosuperior, posterosuperior, or very rarely in the mid-lower mediastinum. Occasionally, parathyroid adenomas may be found within, or lateral to, the carotid sheath. Rarely, the lower parathyroid glands fail to migrate, remaining in the high neck anterior to the carotid bifurcation. Finally, 1.4% to 3.2% of all parathyroid adenomas are intrathyroidal, i.e., embedded completely within the thyroid gland (9).Among the several imaging procedures that have been developed for the detection and localization of parathyroid adenomas, dual-phase scintigraphy with Tc-99m sestamibi combined with ultrasonography is considered the imaging method of choice for pre-operatively localizing parathyroid adenomas. The overall accuracy of dual-phase scintigraphy combined with ultrasonography has been found to be superior to that of other scintigraphic or radiological techniques (10, 11). Studies comparing planar imaging and single photon emission computed tomography (SPECT) have shown significantly increased sensitivity for Tc-99m sestamibi SPECT, thus supporting its routine use prior to surgery (12-14). HEAD AND NECK IMAGING PURPOSETo compare the accuracy of planar scintigraphy, single photon emission computed tomography (SPECT), SPECT-CT, and positron...

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“…In einer Übersichtsarbeit werden 11 Publikationen mit etwa 250 Patienten zusammengefasst, die eine Sensitivität von 89% aufweisen [13]. Die meisten Autoren machen dabei keine Angaben zu möglichen präexis-tenten Schilddrüsenerkrankungen oder Voroperationen bzw.…”

Section: Keine Schilddrüsenerkrankungen Oder Voroperationenunclassified