Value of
Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Hyperparathyroidism, Primary
/ diagnostic imaging
Iodine Radioisotopes
Male
Middle Aged
Minimally Invasive Surgical Procedures
Parathyroidectomy
Patient Selection
Radionuclide Imaging
Radiopharmaceuticals
Sensitivity and Specificity
Single Photon Emission Computed Tomography Computed Tomography
Subtraction Technique
Technetium Tc 99m Sestamibi
Young Adult
Hyperparathyroidism
Mini-invasive surgery
Radionuclide imaging
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
13
05
2018
revised:
18
06
2018
accepted:
26
06
2018
pubmed:
8
7
2018
medline:
28
10
2019
entrez:
8
7
2018
Statut:
ppublish
Résumé
Primary hyperparathyroidism/(PHPT) is one of the most common endocrinological conditions. Surgery remains the only curative option. We have evaluated the performance of double isotope Ninety PHPT patients undergoing parathyroidectomy (December 2015-August 2016) were included. All patients were evaluated with neck ultrasound/(US), PS and SPECT/CT with a new protocol. Outcomes from imaging modalities were reported as: uniglandular disease/(UGD), multiglandular disease/(MGD), or negative, and were compared to post-operative diagnoses. Post-operatively, 72 and 18 patients had true UGD and MGD, respectively. Sensitivities and specificities of US, pinhole scintigraphy with subtraction, pinhole and SPECT/CT with subtraction, and all modalities combined were 91.7%/38.9%, 88.9%/72.2%, 93%/66.7% and 84.72%/77.78%, respectively: specificity of US + PS superior to US alone, p = 0.074. SPECT/CT enables reclassification of doubtful uptake foci. Combination of neck US and PS with subtraction SPECT/CT offers a higher specificity for guiding towards minimally invasive parathyroidectomy.
Sections du résumé
BACKGROUND
Primary hyperparathyroidism/(PHPT) is one of the most common endocrinological conditions. Surgery remains the only curative option. We have evaluated the performance of double isotope
METHODS
Ninety PHPT patients undergoing parathyroidectomy (December 2015-August 2016) were included. All patients were evaluated with neck ultrasound/(US), PS and SPECT/CT with a new protocol. Outcomes from imaging modalities were reported as: uniglandular disease/(UGD), multiglandular disease/(MGD), or negative, and were compared to post-operative diagnoses.
RESULTS
Post-operatively, 72 and 18 patients had true UGD and MGD, respectively. Sensitivities and specificities of US, pinhole scintigraphy with subtraction, pinhole and SPECT/CT with subtraction, and all modalities combined were 91.7%/38.9%, 88.9%/72.2%, 93%/66.7% and 84.72%/77.78%, respectively: specificity of US + PS superior to US alone, p = 0.074. SPECT/CT enables reclassification of doubtful uptake foci.
CONCLUSIONS
Combination of neck US and PS with subtraction SPECT/CT offers a higher specificity for guiding towards minimally invasive parathyroidectomy.
Identifiants
pubmed: 29980283
pii: S0002-9610(18)30687-1
doi: 10.1016/j.amjsurg.2018.06.027
pii:
doi:
Substances chimiques
Iodine Radioisotopes
0
Radiopharmaceuticals
0
Iodine-123
8YWR746RPQ
Technetium Tc 99m Sestamibi
971Z4W1S09
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
108-113Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.