T H Vu1, D Schellingerhout2, N Guha-Thakurta2, J Sun3, W Wei3, S C Kappadth4, N Perrier5, E E Kim6, E Rohren7, H H Chuang8, F C Wong8. 1. From the Departments of Diagnostic Radiology (T.H.V., D.S., N.G.-T.) thinh.vu@mdanderson.org. 2. From the Departments of Diagnostic Radiology (T.H.V., D.S., N.G.-T.). 3. Biostatistics (J.S., W.W.). 4. Imaging Physics (S.C.K.). 5. Surgical Oncology (N.P.). 6. Department of Radiological Sciences (E.E.K.), University of California at Irvine, Orange, California. 7. Baylor College of Medicine (E.R.), Houston, Texas. 8. Nuclear Medicine (H.H.C., F.C.W.), The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND AND PURPOSE: Minimally invasive parathyroid surgery relies critically on image guidance, but data comparing the efficacy of various imaging modalities are scarce. Our aim was to perform a blinded comparison of the localizing capability of technetium Tc99m sestamibi SPECT, multiphase multidetector 4D CT, and the combination of these 2 modalities (technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT). MATERIALS AND METHODS: We reviewed the records of 31 (6 men, 25 women; median age, 56 years) consecutive patients diagnosed with biochemically confirmed primary hyperparathyroidism between November 2009 and March 2010 who underwent preoperative technetium Tc99m sestamibi SPECT and multiphase multidetector 4D CT performed on the same scanner with pathologic confirmation by resection of a single parathyroid adenoma. Accuracy was determined separately for localization to the correct side and quadrant using surgical localization as the standard of reference. RESULTS: Surgical resection identified 14 left and 17 right parathyroid adenomas and 2 left inferior, 12 left superior, 11 right inferior, and 6 right superior parathyroid adenomas. For left/right localization, technetium Tc99m sestamibi SPECT achieved an accuracy of 93.5% (29 of 31), multiphase multidetector 4D CT achieved 96.8% accuracy (30 of 31), and technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT achieved 96.8% accuracy (30 of 31). For quadrant localization, technetium Tc99m sestamibi SPECT accuracy was 67.7% (21 of 31), multiphase multidetector 4D CT accuracy was 87.1% (27 of 31), and technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT accuracy was 93.5% (29 of 31). Reader diagnostic confidence was consistently ranked lowest for technetium Tc99m sestamibi SPECT and highest for technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT. CONCLUSIONS: For left/right localization of parathyroid adenomas, all modalities performed equivalently. For quadrant localization, technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT is superior to technetium Tc99m sestamibi SPECT.
BACKGROUND AND PURPOSE: Minimally invasive parathyroid surgery relies critically on image guidance, but data comparing the efficacy of various imaging modalities are scarce. Our aim was to perform a blinded comparison of the localizing capability of technetium Tc99m sestamibi SPECT, multiphase multidetector 4D CT, and the combination of these 2 modalities (technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT). MATERIALS AND METHODS: We reviewed the records of 31 (6 men, 25 women; median age, 56 years) consecutive patients diagnosed with biochemically confirmed primary hyperparathyroidism between November 2009 and March 2010 who underwent preoperative technetium Tc99m sestamibi SPECT and multiphase multidetector 4D CT performed on the same scanner with pathologic confirmation by resection of a single parathyroid adenoma. Accuracy was determined separately for localization to the correct side and quadrant using surgical localization as the standard of reference. RESULTS: Surgical resection identified 14 left and 17 right parathyroid adenomas and 2 left inferior, 12 left superior, 11 right inferior, and 6 right superior parathyroid adenomas. For left/right localization, technetium Tc99m sestamibi SPECT achieved an accuracy of 93.5% (29 of 31), multiphase multidetector 4D CT achieved 96.8% accuracy (30 of 31), and technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT achieved 96.8% accuracy (30 of 31). For quadrant localization, technetium Tc99m sestamibi SPECT accuracy was 67.7% (21 of 31), multiphase multidetector 4D CT accuracy was 87.1% (27 of 31), and technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT accuracy was 93.5% (29 of 31). Reader diagnostic confidence was consistently ranked lowest for technetium Tc99m sestamibi SPECT and highest for technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT. CONCLUSIONS: For left/right localization of parathyroid adenomas, all modalities performed equivalently. For quadrant localization, technetium Tc99m sestamibi SPECT + multiphase multidetector 4D CT is superior to technetium Tc99m sestamibi SPECT.
Authors: Lee F Starker; Amit Mahajan; Peyman Björklund; Gordon Sze; Robert Udelsman; Tobias Carling Journal: Ann Surg Oncol Date: 2010-12-24 Impact factor: 5.344
Authors: Russell B Smith; Maria Evasovich; Douglas A Girod; Jeffrey B Jorgensen; William M Lydiatt; Nitin A Pagedar; Willam C Spanos Journal: Otolaryngol Head Neck Surg Date: 2013-06-07 Impact factor: 3.497
Authors: Sherif I Heiba; Manli Jiang; Javier Rivera; Eric Genden; William Inabnet; Josef Machac; Lale Kostakoglu Journal: Clin Nucl Med Date: 2015-06 Impact factor: 7.794
Authors: Martin Krakauer; Bente Wieslander; Peter S Myschetzky; Anke Lundstrøm; Theis Bacher; Christian H Sørensen; Waldemar Trolle; Birte Nygaard; Finn N Bennedbæk Journal: Clin Nucl Med Date: 2016-02 Impact factor: 7.794
Authors: George J Hunter; Dawid Schellingerhout; Thinh H Vu; Nancy D Perrier; Leena M Hamberg Journal: Radiology Date: 2012-07-12 Impact factor: 11.105
Authors: W Jalloul; R Tibu; T M Ionescu; C R Stolniceanu; I Grierosu; A Tarca; L Ionescu; M C Ungureanu; D Ciobanu; V Ghizdovat; C Stefanescu Journal: Acta Endocrinol (Buchar) Date: 2021 Jul-Sep Impact factor: 0.877
Authors: Steven Raeymaeckers; Yannick De Brucker; Tim Vanderhasselt; Nico Buls; Johan De Mey Journal: BMC Med Imaging Date: 2021-04-07 Impact factor: 1.930