Background Hungry bone syndrome (HBS) following parathyroidectomy is associated with severe hypocalcemia and increased morbidity. This study aims to determine the incidence and risk factors of post-parathyroidectomy HBS in dialysis patients with secondary hyperparathyroidism (SHPT). Methods A retrospective cohort study was conducted, and medical records of patients with SHPT requiring parathyroidectomy between January 2014 and January 2020 were reviewed. HBS was defined as the requirement of intravenous calcium administration due to hypocalcemia-related symptoms and/or reductions in serum calcium concentration (<8.4 mg/dL) within 72 h after parathyroidectomy. Results A total of 130 dialysis patients were enrolled. The majority of patients (85.4%) received hemodialysis and the remaining patients (14.6%) received peritoneal dialysis. Ectopic parathyroid glands were identified in 6.6% of patients by preoperative parathyroid scintigraphy. Diffuse parathyroid hyperplasia was the most common histopathological characteristic of SHPT (90.8%). HBS occurred in 82.3% of patients following parathyroidectomy. Preoperative serum intact parathyroid hormone (iPTH) concentration was significantly correlated with serum calcium ( r = −0.48, p < 0.01) and alkaline phosphatase (ALP) concentration ( r = 0.71, p < 0.01). Patients with HBS had significantly longer hospital stays than patients without (8 versus 3 days, p < 0.01). Based on multiple logistic regression analysis, young age (≤45 years), high preoperative serum ALP (>420 IU/L) and iPTH (>1,000 pg/mL), and absence of preoperative hypercalcemia (>10.2 mg/dL) were significantly associated with HBS. Conclusions Post-parathyroidectomy HBS is common in dialysis patients with SHPT. Young age, high preoperative serum ALP and iPTH, and low preoperative serum calcium concentrations were important risk factors for HBS.

BACKGROUND: Several parathyroid scintigraphy protocols have been used for preoperative localization of hyperfunctioning parathyroid glands in patients with hyperparathyroidism. The aim of this study is to compare the diagnostic accuracy of vari-

Purpose Diagnostic I-131 MIBG scintigraphy is an important imaging modality for evaluation of patients with neuroblastoma (NB) especially in centers where I-123 MIBG is not available. Single photon emission computed tomography/computed tomography (SPECT/CT) could potentially improve lesion detection over planar scintigraphy, but studies regarding its usefulness as an add-on to diagnostic I-131 MIBG scintigraphy are limited. This study aimed to determine the usefulness and factors related to usefulness of SPECT/CT in diagnostic I-131 MIBG scintigraphy in NB patients. Methods Usefulness of SPECT/CT for lesion detection, lesion localization, resolving suspicious findings, and clarifying the nature of lesions on anatomical imaging were retrospectively reviewed in 86 diagnostic planar I-131 MIBG scintigrams with addon SPECT/CT. Results SPECT/CT detected additional lesions in 23.2%(20/86), helped localize lesions in 21.1%(8/38), resolved suspicious findings in 85.7%(6/7), determined functional status of lesions on anatomical imaging in 94.4%(17/18), and changed diagnosis from a negative to a positive study in 19.5%(8/41). Independent predictors of SPECT/CT being useful included presence of suspicious findings on planar imaging (OR 99.08; 95% C.I. 6.99-1404.41; p = 0.001), positive findings on planar imaging (OR 4.61; 95% C.I. 1.05, 20.28; p < 0.001), and presence of structural lesions on anatomical imaging (OR 32.54;; p < 0.001). Conclusion SPECT/CT is a useful add-on to diagnostic planar I-131 MIBG scintigraphy. Predictors of usefulness of SPECT/CT include suspicious or positive findings on planar scintigraphy and the presence of structural lesions on anatomical imaging.

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Objective: To find prevalence and causes of fluorodeoxyglucose (FDG)-avid mediastinal lymph nodes in patients with colorectal cancer in a tuberculosis-endemic area.Material and Methods: For this study we enrolled patients with colorectal cancer who underwent Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT). Then, PET/CT images were reviewed by a nuclear medicine physician to find mediastinal lymph nodes with FDG uptake beyond the lung background defined as FDG-avid node. The degree of FDG uptake was graded and measured, and associated factors for presence of FDG-avid nodes were evaluated. The causes of FDG-avid nodes were also determined.Results: A total of 109 patients (64 males; mean age 61.2 years) were studied. Seventy-five patients had FDG-avid mediastinal nodes; accounting for a prevalence of 68.8% (95% CI: 59.2-77.3%). Most of the patients had multiple and bilateral nodes; with the zones of hilar and interlobar being the most common location. Age ≥50 years was the only associated factor for FDG-avid nodes (OR of 3.16, p-value=0.035). Only one out of the 32 patients (with fulfilled followup criteria) had a metastatic node.Conclusion: The prevalence of FDG-avid mediastinal nodes in colorectal cancer patients in a tuberculosis-endemic area was significantly high. Most of the lesions were benign in nature; thus, interpretation of these findings should be considered carefully to avoid false-positive results.