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Preoperative 99mTc-sestamibi scintigraphy in patients with primary hyperparathyroidism and concomitant nodular goiter: Comparison of SPECT-CT, SPECT, and planar imaging

Shafiei, B. and Hoseinzadeh, S. and Fotouhi, F. and Malek, H. and Azizi, F. and Jahed, A. and Hadaegh, F. and Salehian, M. and Parsa, H. and Javadi, H. and Assadi, M. (2012) Preoperative 99mTc-sestamibi scintigraphy in patients with primary hyperparathyroidism and concomitant nodular goiter: Comparison of SPECT-CT, SPECT, and planar imaging. Nuclear Medicine Communications, 33 (10). pp. 1070-1076. ISSN 01433636 (ISSN)

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Abstract

Background: Investigations using a hybrid single photon emission computed tomography/computed tomography (SPECT-CT) scanning technique have been carried out in limited studies and have shown mixed results. However, the assessment of this technique for the detection of parathyroid adenoma in patients with a nodular goiter was performed in only one study with a small sample size. The aim of this prospective study was to assess the role of Tc-sestamibi parathyroid SPECT-CT scans for localization of parathyroid adenomas with a concomitant nodular goiter using Tc-methoxyisobutyl isonitrile (MIBI) scintigraphy and to compare it with SPECT and planar imaging. Methods: This study was conducted on 48 patients with primary hyperparathyroidism and nodular goiter, who were candidates for parathyroid surgery and had been referred for parathyroid scintigraphy. The patients underwent an early set of planar Tc-MIBI scanning procedures first, followed by SPECT and CT scannings, and finally a delayed set of planar Tc-MIBI scannings. Sensitivity, specificity, negative and positive predictive values, and accuracy were determined on a per-parathyroid-gland basis for each scanning method, as defined by histology and follow-up. Results: The surgery was successful in 48 out of 50 patients with primary hyperparathyroidism concomitant with thyroid nodularity, and data were completed for 80 sites in 48 patients. The accuracy of SPECT-CT in correctly identifying a parathyroid adenoma was 85.00, versus 75.00% for SPECT (P=0.01, significant). The sensitivity and specificity for SPECT-CT were 77.55 and 96.77%, respectively, versus 67.34 and 87.09%, respectively, for SPECT (P=0.12 and 0.12, not significant). There were nine sites that showed better localization on SPECT-CT scans relative to SPECT images, of which five sites were located in the ectopic regions. Conclusion: The results of our study indicate that SPECT-CT is more accurate than sestamibi planar imaging and SPECT for the preoperative identification of parathyroid lesions in patients with primary hyperparathyroidism concomitant with thyroid nodularity. Also, we would recommend the use of SPECT-CT for a workup of all patients with ectopic glands who are scheduled for minimally invasive parathyroid surgery. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Nucl. Med. Commun. [Field not mapped to EPrints] C2 - 22825041 [Field not mapped to EPrints] AD - Department of Nuclear Medicine, Erfan Hospital, Iran [Field not mapped to EPrints] AD - Department of Nuclear Medicine, Taleghani Hospital, Iran [Field not mapped to EPrints] AD - Departement of Surgery, Taleghani Hospital, Iran [Field not mapped to EPrints] AD - Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Iran [Field not mapped to EPrints] AD - Department of Nuclear Medicine, Shaheed Rajaei Heart Center, Tehran University of Medical Sciences, Iran [Field not mapped to EPrints] AD - Booali General Hospital, Islamic Azad University, Tehran Medical Branch, Tehran, Iran [Field not mapped to EPrints] AD - Department of Surgery, Shahid Rajaee Hospital, Qazvin University of Medical Sciences, Qazvin, Iran [Field not mapped to EPrints] AD - Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr 3631, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid scintigraphy, single photon emission computed tomography-computed tomography, methoxy isobutyl isonitrile technetium tc 99m, diagnostic agent, methoxy isobutyl isonitrile technetium tc 99m, adult, aged, article, computed tomography scanner, computer assisted tomography, diagnostic accuracy, diagnostic imaging, diagnostic value, female, human, hyperparathyroidism, image analysis, intermethod comparison, major clinical study, male, nodular goiter, parathyroid scintiscanning, planar scintigraphy imaging, prospective payment, sensitivity and specificity, single photon emission computer tomography, single photon emission computer tomography computed tomography, clinical trial, comparative study, computer assisted emission tomography, methodology, middle aged, nodular goiter, parathyroid gland, parathyroid tumor, preoperative period, primary hyperparathyroidism, scintiscanning, Adult, Aged, Aged, 80 and over, Female, Goiter, Nodular, Humans, Hyperparathyroidism, Primary, Male, Middle Aged, Parathyroid Glands, Parathyroid Neoplasms, Positron-Emission Tomography and Computed Tomography, Preoperative Period, Technetium Tc 99m Sestamibi, Tomography, Emission-Computed, Single-Photon
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 19 Apr 2015 06:04
Last Modified: 13 May 2015 05:08
URI: http://eprints.goums.ac.ir/id/eprint/1968

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