PURPOSE: To find out if single-photon emission computed tomography (SPECT) and (123)I-subtraction can enhance the findings of (99m)Tc-methoxyisobutylisonitrile (MIBI) scintigraphy for the preoperative localization of parathyroid (PT) tumors. METHODS: Among the 111 consecutive patients who underwent preoperative planar (99m)Tc-MIBI scintigraphy for hyperparathyroidism (HPT), 64 underwent delayed SPECT, and 17 underwent (123)I-subtraction. Two independent blinded experts scored the topographical localization, diagnostic confidence, and impact of each diagnostic modality on the surgical strategy. RESULTS: For adenomas, (99m)Tc-MIBI scintigraphy had a sensitivity of 77% with a positive predictive value (PPV) of 83%. SPECT did not affect the sensitivity or PPV, but it increased the diagnostic confidence and changed the surgical strategy in 21% of the patients. (123)I-subtraction increased the sensitivity from 64% to 82%, but decreased the PPV from 88% to 82%. In hyperplastic glands, (99m)Tc-MIBI scintigraphy had a sensitivity of 47% and a PPV of 95%. When (99m)Tc-MIBI scintigraphy was combined with SPECT and (123)I-subtraction, the results were 44%/10% and 52%/92%, respectively. Both SPECT and (123)I-subtraction decreased the diagnostic confidence. CONCLUSIONS: Adding SPECT to (99m)Tc-MIBI scintigraphy improved the surgical decision for parathyroid adenomas. The addition of (123)I-subtraction was of limited value. For hyperplastic glands, (99m)Tc-MIBI scintigraphy was relatively ineffective, even with the addition of SPECT or (123)I-subtraction.
PURPOSE: To find out if single-photon emission computed tomography (SPECT) and (123)I-subtraction can enhance the findings of (99m)Tc-methoxyisobutylisonitrile (MIBI) scintigraphy for the preoperative localization of parathyroid (PT) tumors. METHODS: Among the 111 consecutive patients who underwent preoperative planar (99m)Tc-MIBI scintigraphy for hyperparathyroidism (HPT), 64 underwent delayed SPECT, and 17 underwent (123)I-subtraction. Two independent blinded experts scored the topographical localization, diagnostic confidence, and impact of each diagnostic modality on the surgical strategy. RESULTS: For adenomas, (99m)Tc-MIBI scintigraphy had a sensitivity of 77% with a positive predictive value (PPV) of 83%. SPECT did not affect the sensitivity or PPV, but it increased the diagnostic confidence and changed the surgical strategy in 21% of the patients. (123)I-subtraction increased the sensitivity from 64% to 82%, but decreased the PPV from 88% to 82%. In hyperplastic glands, (99m)Tc-MIBI scintigraphy had a sensitivity of 47% and a PPV of 95%. When (99m)Tc-MIBI scintigraphy was combined with SPECT and (123)I-subtraction, the results were 44%/10% and 52%/92%, respectively. Both SPECT and (123)I-subtraction decreased the diagnostic confidence. CONCLUSIONS: Adding SPECT to (99m)Tc-MIBI scintigraphy improved the surgical decision for parathyroid adenomas. The addition of (123)I-subtraction was of limited value. For hyperplastic glands, (99m)Tc-MIBI scintigraphy was relatively ineffective, even with the addition of SPECT or (123)I-subtraction.
Authors: E Hindié; P Urenã; C Jeanguillaume; D Mellière; J M Berthelot; V Menoyo-Calonge; D Chiappini-Briffa; A Janin; P Galle Journal: Lancet Date: 1999-06-26 Impact factor: 79.321
Authors: A Staudenherz; C Abela; B Niederle; E Steiner; T Helbich; S Puig; K Kaserer; A Becherer; T Leitha; K Kletter Journal: Eur J Nucl Med Date: 1997-02
Authors: F Lumachi; A Tregnaghi; P Zucchetta; M C Marzola; D Cecchin; P Marchesi; F Fallo; F Bui Journal: Br J Radiol Date: 2004-02 Impact factor: 3.039
Authors: Eeva M Ryhänen; Jukka Schildt; Ilkka Heiskanen; Mika Väisänen; Aapo Ahonen; Eliisa Löyttyniemi; Camilla Schalin-Jäntti; Matti J Välimäki Journal: Int J Mol Imaging Date: 2015-02-01