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Contribution of early SPECT/CT to 99mTc-MIBI double phase scintigraphy in primary hyperparathyroidism: Diagnostic value and correlation between uptake and biological parameters.
García-Talavera, P; Díaz-Soto, G; Montes, A A; Villanueva, J G; Cobo, A; Gamazo, C; Ruiz, M Á; González-Selma, M L.
Afiliação
  • García-Talavera P; Servicio de Medicina Nuclear, Hospital Clínico Universitario de Salamanca, Salamanca, Spain. Electronic address: palomagtalavera@gmail.com.
  • Díaz-Soto G; Servicio de Endocrinología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Montes AA; Servicio de Radiodiagnóstico, Hospital Universitario Río Hortega, Valladolid, Spain.
  • Villanueva JG; Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Cobo A; Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Gamazo C; Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • Ruiz MÁ; Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
  • González-Selma ML; Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Rev Esp Med Nucl Imagen Mol ; 35(6): 351-357, 2016.
Article em En, Es | MEDLINE | ID: mdl-27132216
AIM: To evaluate the value of 99mTc-MIBI double-phase scintigraphy (DPS) and early SPECT/CT in the pre-surgical assessment of patients with primary hyperparathyroidism (PHPT). Also, to calculate the correlation between uptake and some biological parameters. MATERIAL AND METHODS: Forty patients with PHPT were included: 37 solitary adenomas, 1 hyperplasia, and 2 double adenomas. Fifteen patients had ectopic glands. DPS and early SPECT/CT were acquired in all patients. Ultrasound was performed in 31/40. All patients underwent surgery, intra-operative iPTH measurements, and histopathological examinations. Qualitative DPS uptake was assessed and correlated to pre-surgical calcium, iPTH levels, gland weight, and maximum diameter. RESULTS: In the planar study, there were 23 positive cases, 8 doubtful, and 9 negatives. With the SPECT/CT, 8/9 negatives cases were located. All doubtful cases were confirmed as positives. Gland location improved in 16 cases (12 ectopic). DPS+SPECT/CT failed to detect a solitary adenoma and at least one gland in three cases of multiglandular disease (MGD). The sensitivity by patient was: DPS 72.5%, DPS+SPECT/CT 90%, and ultrasound 42%. Ultrasound and scintigraphy (DPS+SPECT/CT) were concordant in 16/31 patients. For the rest of them, scintigraphy proved correct in 14/15, and both techniques failed in one case. There was a significant correlation between level of uptake and iPTH level, gland weight, and maximum diameter. CONCLUSION: Early SPECT/CT improves sensitivity and the locating of parathyroid pathological glands and increases diagnostic confidence. iPTH level, glandular size, and weight are related to the qualitative assessment of 99mTc-MIBI uptake in early DPS.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cintilografia / Tecnécio Tc 99m Sestamibi / Compostos Radiofarmacêuticos / Hiperparatireoidismo Primário / Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único Tipo de estudo: Diagnostic_studies / Observational_studies / Qualitative_research / Screening_studies Limite: Female / Humans / Male / Middle aged Idioma: En / Es Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cintilografia / Tecnécio Tc 99m Sestamibi / Compostos Radiofarmacêuticos / Hiperparatireoidismo Primário / Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único Tipo de estudo: Diagnostic_studies / Observational_studies / Qualitative_research / Screening_studies Limite: Female / Humans / Male / Middle aged Idioma: En / Es Ano de publicação: 2016 Tipo de documento: Article