Technetium‐99m‐MIBI SPECT/CT in Primary Hyperparathyroidism

Krausz, Yodphat; Bettman, Lise; Guralnik, Ludmila; Yosilevsky, Galina; Keidar, Zohar; Bar‐Shalom, Rachel; Even-Sapir, Einat; Chisin, Roland; Israel, Ora

doi:10.1007/s00268-005-7849-2

Cited by 127 publications

(104 citation statements)

References 32 publications

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“…Also, Gayed et al reported that SPECT/CT was only of limited value (8% of patients) (48). On the contrary, a retrospective study indicated a change in therapeutic management for 39% of patients (14/36) because of the localization of ectopic parathyroid adenomas or accurate localization in patients with distorted neck anatomy (49). Because of some inconsistent reports, a definite role of SPECT/CT in the imaging of parathyroid adenomas has not yet been indicated, and evaluations with larger patient cohorts are needed.…”

Section: Spect/ct In Parathyroid Tumorsmentioning

confidence: 99%

Spect/Ct

Buck¹,

Nekolla²,

Ziegler³

et al. 2008

J Nucl Med

281

149

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In view of the commercial success of integrated PET/CT scanners, there is an increasing interest in comparable SPECT/CT systems. SPECT in combination with CT enables a direct correlation of anatomic information and functional information, resulting in better localization and definition of scintigraphic findings. Besides anatomic referencing, the added value of CT coregistration is based on the attenuation correction capabilities of CT. The number of clinical studies is limited, but pilot studies have indicated a higher specificity and a significant reduction in indeterminate findings. The superiority of SPECT/CT over planar imaging or SPECT has been demonstrated in bone scintigraphy, somatostatin receptor scintigraphy, parathyroid scintigraphy, and adrenal gland scintigraphy. Also, rates of detection of sentinel nodes by biopsy can be increased with SPECT/CT. This review highlights recent technical developments in integrated SPECT/CT systems and summarizes the current literature on potential clinical uses and future directions for SPECT/CT in cardiac, neurologic, and oncologic applications.

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Section: Spect/ct In Parathyroid Tumorsmentioning

confidence: 99%

Spect/Ct

Buck¹,

Nekolla²,

Ziegler³

et al. 2008

J Nucl Med

281

149

View full text Add to dashboard Cite

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“…The task presents an additional obstacle due to the close vicinity of the thyroid gland which affects the precision of the examination (pinpointing voxel position) [24]. In these circumstances proposing a relatively simple, repeatable method of focal lesion metabolic activity assessment, as is the case with TBR, allows a much more precise differentiation of these foci.…”

Section: Discussionmentioning

confidence: 99%

Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study

et al. 2017

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BBACKGROUND:The aim of this paper was to analyse our own semi-quantitative method of assessing focal lesions localised in pre-operative diagnostic scintigraphy of primary hyperparathyroidism (PHPT) using 99m Tc-MIBI with washout and comparing these data with the result of the histopathological examination (HP). MATERIAL AND METHODS:A total of 40 (37 female, 3 male, average age 58.7 years) patients with a suspicion of PHPT were enrolled for prospective analysis. Dual phase planar and SPECT/CT examination with 99m Tc-MIBI were performed. The tumour to background ratios in the 10 th and 120 th minute were calculated (TBR10 and TBR120) on the basis of the planar acquisition.PTH, ionised calcium and phosphate levels were measured.Parathyroid surgery alone or combined with subtotal/total thyreoidectomy was conducted in 23 (57.5%) and 17 (42.5%) patients, respectively. A HP was performed in all patients. RESULTS:Average concentration of PTH in the whole group was 243.95 pg/ml. There was a statistically significant correlation between medians of PTH concentration and parathyroid histopathological results (p = 0.01). A total of 45 lesions of increased uptake were found in 32 (80.0%) and 34 (85%) patients in the early phase and the delayed phase, respectively.The post-operative material contained 20 (44.5%) parathyroid adenomas, 11 (24.5%) cases of hyperplasia, 2 (4.4%) cancers, 4 (8.9%) cases of normal parathyroid tissue, 2 (4.4%) lymph nodes and 6 (13.3%) cases of thyroid gland tissue.The medians of TBR10 and TBR120 for lesions examined in the HP were respectively: 3.64 and 2.59 for adenoma; 3.08 and 2.18 for hyperplasia; 7.7 and 5.5 for parathyroid cancer, 4.89 and 3.16 for normal tissue and 5.26 and 2.95 for lymph nodes or thyroid gland tissue.A high correlation coefficient of TBR10 to TBR120 in the parathyroid adenoma and parathyroid hyperplasia groups was observed with r = 0.867 and r = 0.964, respectively. The ρr correlation coefficient of TBR10 to TBR120 for normal parathyroid was 0.4.There was a statistically significant association between the HP and TBR10 medians (p = 0.047), but not between histopathology and TBR120 medians (p = 0.840

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“…Deux études récentes ont montré que la P-TEMP/TDM s'avère surtout utile pour préciser la localisation des LP ectopiques ou des LP orthotopiques après remaniements post chirurgicaux de la région cervicale ou en l'absence de thyroïde [41][42]. L'information morphologique de la TDM …”

Section: Discussionunclassified

Tomographie sténopéïque au 99mTc-MIBI dans l’hyperparathyroïdie primaire

et al. 2007

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Amélioration de la détection des lésions par la tomographie sténopéïque au MIBI-Tc 99m dans l'hyperparathyroïdie primaire. Tc 99m -MIBI pinhole SPECT in primary hyperparathyroidism: improvement of parathyroid lesion detection.Oudoux A 1 , Carlier T 1 , Mirallié E 2 , Bodet-Milin C 1 , Seret A 3 , Defrise M 4 , Aubron F 5 , Daumy I 5 , Leux C 6 , Kraeber-Bodéré F 1 et Ansquer C 1 . Methods: Fifty one patients cured after surgery were studied. pSPECT was reconstructed with a dedicated OSEM algorithm. A diagnostic confidence score (CS) was assigned to each procedure considering intensity and extra-thyroidal location of suspected lesions and was defined as follows: 0 = negative, 1 = doubtful, 2 = moderately positive, 3 = positive.Results: Surgery revealed 55 lesions. Sensitivity of ultrasonography, planar imaging, cSPECT and pSPECT were respectively 51%, 76%, 82% and 87%. Five glands were only detected by pSPECT. Combination of ultrasonography, planar and pSPECT showed the highest sensitivity (94.5%). The mean CS of the 55 pathologic glands was significantly higher with pSPECT compared with planar imaging and cSPECT (p<0.0001). Compared with planar imaging and cSPECT, pSPECT increased CS for 42% and 53% of parathyroid lesions respectively, and contributed to markedly reduce the number of uncertain results.Nevertheless, planar imaging and ultrasonography were useful to analyze thyroid morphology and to detect some ectopic glands. Conclusion:The use of pSPECT increases sensitivity and CS of scintigraphy. Combination of ultrasonography, planar and pSPECT appears to be complementary and the optimal preoperative imaging procedure in primary hyperparathyroidism.

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Technetium‐99m‐MIBI SPECT/CT in Primary Hyperparathyroidism

Cited by 127 publications

References 32 publications

Spect/Ct

Spect/Ct

Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study

Tomographie sténopéïque au 99mTc-MIBI dans l’hyperparathyroïdie primaire

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