Associations of Serum Ionized Calcium, Phosphate, and Pth Levels with Parathyroid Scan in Primary Hyperparathyroidism

Hoang, Thanh D.; Jani, Ami G.; Vinh, Q.; Tuamokumo, Francois O.; Shakir, Mohamed K M

doi:10.4158/ep-2018-0414

Cited by 10 publications

(4 citation statements)

References 20 publications

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“…A Total 75 patients were enrolled for this study, 29 (38.66%) were male and 43(61.34%) were female.Among 75 patients, 4 ( this study showed that most of the gland were located 40.6% (13 out of 32) in inferior to the thyroid gland at the level of C7-D1 vertebrae and 21.8 % (7 out of 32) in ectopic positions. consistent with the present study (8).…”

Section: Resultssupporting

confidence: 94%

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Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Sharmin

Haque

Rahman³

et al. 2019

Bangladesh J. Nuclear Med.

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Objective: Detection of parathyroid adenoma or hyperplasia/ carcinoma by imaging is very challenging.The objective of this study was to assess the imaging findings of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in neck and thorax of patients and correlation with parathyroid hormone (PTH), Serum calcium, Inorganic phosphate(IP), Bone mineral density ( BMD) and also with neck ultrasonography (USG of neck). Material & Methods: A total 75 study subjects were included in this retrospective study conducted from January 2011 to November 2018 in the Institute of Nuclear Medicine and Allied Sciences (INMAS), SSMCH, Mitford, Dhaka. All the patients came in this institute forparathyroid SPECT-CT were included for this study. SPECT-CT findings were compared with USG of neck, serum calcium, inorganic phosphate (IP) level and BMD findings. Results: In this study 29 (38%) were male and 46(62%) were female. Mean PTH was 469±667 pg/ml, range 20-3110pg/ml, mean serum calcium 9.8±1.5 mg/dl with range 6.20 -14.30 mg/dl, mean IP3.00.8 mg/dl with range of 1.7 -4 mg/dl. SPECT-CT positive patients were 32 (42.7%) and negative patients were 43 (53.3%). USG of neck positive patients were 21 (28%) and negative patients were 54 (72%).The PTH (r=0.53, p=0.0) serum Calcium (r=0.66,p= 0.0) positively correlate with SPECT-CT positive patients and negatively with IP level (r=-0.177, p> 0.05). Among 75 the patients, 44 patients had BMD report. 28 (63.6%) patients had SPECT –CT negative findings and 16 (36.4%) patients with positive SPECT-CT findings with P value <0.05. Conclusion: This study showed the positivity of SPECT-CT parathyroid imaging positively correlate with PTH, s.ca and inversely correlate with IP. This study also showed that SPECT-CT is better than USG of neck not only localization of parathyroid gland in normal anatomical position but also in ectopic position. Bangladesh J. Nuclear Med. 21(2): 69-72, July 2018

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Section: Resultssupporting

confidence: 94%

“…Again SPECT-CT positive patients were 16 in numbers, among them 3 had normal BMD value, 5 had osteopenia and 8 had osteoporosis. This findings was consistent with a study conducted by Hoang et al 2018.…”

Section: Resultssupporting

confidence: 94%

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Sharmin

Haque

Rahman³

et al. 2019

Bangladesh J. Nuclear Med.

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“…Formerly published data provided evidence that PTH is significantly higher in parathyroid scan true positive patients (12). Also recent study by Hoang et al found an association between positive 99m Tc-MIBI scan and higher serum ionised calcium, increased intact PTH levels and lower phosphataemia (13). However, an association between PTH and parathyroid scan positivity was not confirmed by Dy et al (14).…”

Section: Discussionmentioning

confidence: 99%

Dual Tracer 99mTc-Pertechnetate/99mTc-MIBI Dual-Time-Point SPECT/CT Parathyroid Gland Assessment Regarding to Parathyroid Gland Size and Biochemical Parameters – Two Years Single Imaging Centre Experience

Krčálová

Horáček

Nováková³

et al. 2019

Acta Med. (Hradec Kralove, Czech Repub.)

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Introduction: Preoperative parathyroid imaging is inevitable part of focused parathyroid surgery. The aim of our study was assessment of parathyroid scintigraphy diagnostic accuracy regarding to size and metabolic parameters of hyperfunctioning parathyroid tissue. Material and methods: Parathyroid scintigraphy for suspected primary hyperparathyroidism was performed in 95 patients during years 2015 and 2016. Of them, 75 patients with known clinical outcome (40 underwent surgery, 35 had documented laboratory follow-up) were further retrospectively evaluated. The performance of dual tracer 99mTc-pertechnetate and 99mTc-MIBI subtraction and dual-time-point 99mTc-MIBI imaging with SPECT/CT was analysed. Serum parathyroid hormone (PTH), calcaemia, ionized calcaemia and phosphataemia and ultrasound detected adenoma volume and largest diameter in false negative and true positive findings were compared using Mann-Whitney test. Results: Sensitivity and specificity of parathyroid scintigraphy was 74.5% and 95.8%, respectively. NPV was 63.8% and PPV 97.4%. Hyperfunctioning parathyroid tissue detectability was almost significantly associated with hypophosphataemia and PTH levels. Conclusion: Parathyroid scintigraphy provides high sensitivity and superior specificity in parathyroid adenoma location, nevertheless the diagnostic accuracy tends to decline in smaller adenomas and in less metabolically active parathyroid tissue causing only subtle biochemical changes. 18F-Fluorocholine PET/CT or 3D SPECT/CT subtraction should be a reasonable option for those cases.

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“…24 Whilst in Hoang et al study of 218 patients, preoperative PTH levels exceeding 90pg/ml were around seven times more likely to have a localising (positive) 99m Tc-sestamibi compared to patients with PTH levels below this value. 25 Being able to predict the likelihood of a localising 99m Tc-sestamibi scan based on preoperative PTH levels could help inform clinicians as to whether a 99m Tc-sestamibi scan or an alternative radiological imaging modality would be best suited to localise the parathyroid adenoma.…”

Section: Comparisons With Other Studiesmentioning

confidence: 99%

Factors related to a non‐localising technetium 99m sestamibi scan result during parathyroid adenoma imaging in primary hyperparathyroidism

Jackson

Chew

McClean

et al. 2020

Clinical Otolaryngology

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Objectives The aim of this study is to investigate factors that are associated with having a non‐localising 99mTc‐sestamibi scan. Design A retrospective study was performed on patients that underwent parathyroid surgery performed within a single institution between 2001 and 2018. Setting Single tertiary centre for parathyroid surgery. Participants 230 patients underwent surgery for primary hyperparathyroidism due to a solitary parathyroid adenoma and had preoperative 99mTc‐sestamibi imaging. Main outcome measures Variables including age, gender, intra‐operative location of parathyroid adenoma, adenoma weight and pre‐ and postoperative calcium and parathyroid hormone levels were investigated through univariate and multivariate analysis to identify any association with having a non‐localising (negative) 99mTc‐sestamibi scan result. Results Multivariate analysis identified that right‐sided adenomas (P = .038), superior adenomas (P = .042) and a lower preoperative PTH level (P = .034) were all individual factors associated with having a negative 99mTc‐sestamibi scan result. Although the weight of the adenoma was significant on univariate analysis (P = .029), this was not demonstrated on multivariate analysis (P = .422). Conclusion Factors that were associated with having non‐localising 99mTc‐sestamibi scan were right‐sided adenomas, superior adenomas and lower preoperative PTH level. Further large prospective multicentre studies are needed to further evaluate these initial findings.

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Associations of Serum Ionized Calcium, Phosphate, and Pth Levels with Parathyroid Scan in Primary Hyperparathyroidism

Cited by 10 publications

References 20 publications

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Dual Tracer 99mTc-Pertechnetate/99mTc-MIBI Dual-Time-Point SPECT/CT Parathyroid Gland Assessment Regarding to Parathyroid Gland Size and Biochemical Parameters – Two Years Single Imaging Centre Experience

Factors related to a non‐localising technetium 99m sestamibi scan result during parathyroid adenoma imaging in primary hyperparathyroidism

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