Dual-phase 99mTc sestamibi scintigraphy with neck and thorax SPECT/CT in primary hyperparathyroidism: a single-institution experience.
Clin Nucl Med
; 37(3): 223-8, 2012 Mar.
Article
em En
| MEDLINE
| ID: mdl-22310246
ABSTRACT
PURPOSE:
To assess the diagnostic value of dual-phase (99m)Tc sestamibi scintigraphy with neck and thorax single-photon emission computed tomography/computed tomography (SPECT/CT) in patients with primary hyperparathyroidism, and to analyze the relationships between SPECT/CT data and serum calcium or parathyroid hormone (PTH) concentrations. MATERIALS ANDMETHODS:
(99m)Tc sestamibi scintigraphy was performed in 94 consecutive patients. Images included early and delayed planar neck images and delayed neck and thorax SPECT/CT. Scintigraphy was scored positive or negative.RESULTS:
Fifty-nine sestamibi studies (63%) were positive. SPECT/CT demonstrated a single focus in 56 patients, in usual parathyroid sites in 80% of cases and in unusual sites in the remaining 20% (retrotracheal area, 7%; intrathyroidal, 9%; mediastinum, 4%), and double foci in 3. Serum calcium values were higher in patients with a positive scintigraphy than in those with a negative scintigraphy (2.80 vs. 2.66 mmol/L, P = 0.001) with similar figures for serum PTH values (129 vs. 107 pg/mL, P = 0.0649). In patients with a measurable parathyroid adenoma on integrated CT scan (n = 43), the greatest axial diameter of the adenoma was correlated to serum calcium (r = 0.405, P < 0.0071) or PTH concentrations (r = 0.589, P < 0.0001). Fifty-four patients underwent surgery, 45 with a positive, and 9 with a negative preoperative scintigraphy, resulting in a sensitivity of 92% (95% CI 80-98) and a specificity of 83% (95% CI 36-100).CONCLUSIONS:
Dual-phase (99m)Tc sestamibi scintigraphy with SPECT/CT enables to identify a parathyroid adenoma in about two-thirds of patients with primary hyperparathyroidism and allows the surgeon to plan appropriate surgery. The likelihood of scintigraphy to be positive is affected by calcium or PTH concentrations.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
/
Tecnécio Tc 99m Sestamibi
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Compostos Radiofarmacêuticos
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Tomografia por Emissão de Pósitrons
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Hiperparatireoidismo Primário
/
Imagem Multimodal
Tipo de estudo:
Diagnostic_studies
Limite:
Adolescent
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Adult
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Aged
/
Aged80
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Nucl Med
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
França