Computed axial tomography–MIBI image fusion for preoperative localization in primary hyperparathyroidism

Profanter, Christoph; Prommegger, Rupert; Gabriel, Michael; Moncayo, Roy; Wetscher, Gerold J.; Lang, Thomas; Bale, Reto

doi:10.1016/j.amjsurg.2003.12.012

Cited by 29 publications

(22 citation statements)

References 15 publications

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“…5 Case series have suggested promise for this technique as an evolving method of preoperative localization for PHPT. 18,27 Our results are consistent with these findings.…”

Section: Recherche / Researchsupporting

confidence: 83%

Incremental value and clinical impact of neck sonography for primary hyperparathyroidism: a risk-adjusted analysis

et al. 2013

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Background: Despite the different preoperative imaging modalities available for parathyroid adenoma localization, there is currently no uniform consensus on the most appropriate preoperative imaging algorithm that should be routinely followed prior to the surgical management of primary hyperparathyroidism (PHPT). We sought to determine the incremental value of adding neck ultrasonography to scintigraphy-based imaging tests. Methods:In a single institution, surgically naive patients with PHPT underwent the following localization studies before parathyroidectomy: 1) Tc-99m sestamibi imaging with single photon emission computed tomography/computed tomography (SPECT/CT) or Tc-99m sestamibi imaging with SPECT alone, or 2) ultrasonog raphy in addition to those tests. We retrospectively collected data and performed a multivariate analysis comparing group I (single study) to group II (addition of ultrasonography) and risk of bilateral (BNE) compared with unilateral (UNE) neck exploration. Conclusion:The addition of ultrasonography to SPECT, but not to SPECT/CT, has incremental value in decreasing the extent of surgery during parathyroidectomy, even after adjusting for multiple confounding factors.Contexte : Malgré l'existence de diverses modalités d'imagerie préopératoire pour la localisation de l'adénome parathyroïdien, on déplore actuellement l'absence de consensus en ce qui concerne l'algorithme le plus approprié à suivre au chapitre de l'imagerie préalable à une prise en charge chirurgicale de l'hyperparathyroïdie primaire (HPTP). Nous avons voulu vérifier si l'ajout de l'échographie du cou aux tests d'imagerie scintigraphique offrait une valeur ajoutée.Méthodes : Dans un établissement, des patients atteints d'HPTP n'ayant jamais subi d'intervention chirurgicale ont été soumis à des examens de localisation préparathy-roïdectomie : 1) imagerie au moyen du sestamibi marqué au Tc-99m avec tomographie par émission monophotonique/tomodensitométrie (SPECT/CT), ou imagerie au moyen du sestamibi marqué au Tc-99m avec SPECT seule, our 2) échographie en plus de ces tests. Nous avons recueilli les données rétrospectivement et effectué une analyse multivariée pour comparer le Groupe I (examen seul) au Groupe II (ajout de l'échographie) et la probabilité qu'ils subissent une exploration cervicale bilatérale (ECB) plutôt qu'unilatérale (ECU). Résultats

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“…5 Case series have suggested promise for this technique as an evolving method of preoperative localization for PHPT. 18,27 Our results are consistent with these findings.…”

Section: Recherche / Researchsupporting

confidence: 83%

Incremental value and clinical impact of neck sonography for primary hyperparathyroidism: a risk-adjusted analysis

et al. 2013

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“…Studies have reported specific anatomic localization using this imaging technology, [11][12][13][14] but the accuracy of this specific anatomic localization has never been objectively quantified. The true value of this study is that it quantifies the error between the imaging localization and the intraoperative finding.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of technetium‐99m SPECT‐CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas

et al. 2007

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“…29 There is a false negative rate of up to 22% with sestamibi scans in primary hyperparathyroidism; this is more likely with small adenomas, multigland disease, superior glands, or normal preoperative calcium concentrations. 30 36 Other scanning modalities in use include subtraction scintigraphy, [36][37][38] positron emission tomography scanning, 39 computed axial tomography-sestamibi image fusion, 40 and pinhole single photon emission computed tomography to complement planar scintigraphy views. 36 Intraoperative cytology and/or conventional frozen sections merely confirm tissue type rather than functional status.…”

Section: Will the Parathyroid Frozen Section Soon Be Left Out In The mentioning

confidence: 99%

BEST PRACTICE NO 183: Examination of parathyroid gland specimens

Johnson

Sheffield²,

McNicol³

2005

Journal of Clinical Pathology

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Computed axial tomography–MIBI image fusion for preoperative localization in primary hyperparathyroidism

Cited by 29 publications

References 15 publications

Incremental value and clinical impact of neck sonography for primary hyperparathyroidism: a risk-adjusted analysis

Incremental value and clinical impact of neck sonography for primary hyperparathyroidism: a risk-adjusted analysis

Accuracy of technetium‐99m SPECT‐CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas

BEST PRACTICE NO 183: Examination of parathyroid gland specimens

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