Contrast-enhanced computed tomography does not improve the diagnostic value of parathyroid dual-phase MIBI SPECT/CT

Andersen, Trine Borup; Aleksyniene, Ramune; Boldsen, Søren Kjærgaard; Gade, Michael; Bertelsen, Henrik; Petersen, Lars Jelstrup

doi:10.1097/mnm.0000000000000818

Cited by 5 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although 99m Tc-MIBI SPECT/CT has high sensitivity and performs well in locating ectopic parathyroid, its sensitivity for parathyroid hyperplasia is only 60%, much lower than that of cervical ultrasound (87.5%). It also suggests that 99m Tc-MIBI SPECT/CT is less sensitive to parathyroid hyperplasia than parathyroid adenoma, which is in good accordance with previous studies [ 22 , 25 ]. Torregrosa et al have found that, in secondary hyperparathyroidism, the uptake of 99m Tc-MIBI is correlated with the cell cycle phases.…”

Section: Discussionsupporting

confidence: 92%

“…Stack et al found that parathyroid adenomas that weigh more than 350 mg are optimum for visualization by 99m Tc-MIBI SPECT/CT [ 24 ]. In addition, the sensitivity of 99m Tc-MIBI SPECT/CT could reach 92% when the weight of parathyroid adenoma is greater than 500 mg, and it decreased significantly to 64% in those lesions weighing less than 500 mg [ 25 ]. However, the weight of the lesion was not measured in our study; we only bring the length of the lesion as an indicator, which is easier to use in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors That Affect the Sensitivity of Imaging Modalities in Primary Hyperparathyroidism

Zhu

Liu

et al. 2021

International Journal of Endocrinology

View full text Add to dashboard Cite

Background. Cervical ultrasound, 99mTc-sestamibi single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT), and cervical CT are routinely used in preoperative localization of primary hyperparathyroidism (PHPT). However, false-negative imaging results are also frequently encountered in clinical practice. Exploring the factors that affect the sensitivity of these imaging modalities is important for the surgical management of PHPT patients. Methods. Clinical data of 352 PHPT patients hospitalized in our center from January 2011 to December 2015 were retrospectively collected to evaluate the sensitivity of 3 imaging modalities in the preoperative localization of parathyroid lesions. The ROC curve analysis was used to explore the clinical factors affecting the sensitivity of localization, and the cut-point(s) of related factors were determined. Results. 99mTc-MIBI SPECT/CT has the highest sensitivity among the localization modalities commonly used, reaching 91.1% (86.0%–94.8%). When the lengths of parathyroid lesions were ≤1.3 cm, the sensitivity of neck ultrasonography significantly decreased, while the sensitivity of 99mTc-MIBI SPECT/CT decreased with parathyroid lesions ≤1.3 cm or serum PTH≤252 pg/ml. 99mTc-MIBI SPECT/CT was less effective in localizing the hyperplasia lesions. Neck ultrasonography combined with 99mTc-MIBI SPECT/CT can effectively improve the accuracy of preoperative localization of parathyroid lesions to 96.2% (92.7%–98.1%). Conclusions. Small parathyroid lesion and mild elevation of serum PTH would reduce the accuracy of parathyroid localization in PHPT patients.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Factors That Affect the Sensitivity of Imaging Modalities in Primary Hyperparathyroidism

Zhu

Liu

et al. 2021

International Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…99m Tc-MIBI SPECT/CT, as a classical nuclear medical imaging technique, is often used for preoperative localization in patients with SHPT [ 14 , 15 ]. In our study, as shown in Table 2 , the sensitivity of 99m Tc-MIBI SPECT/CT was higher than that of 99m Tc-MIBI planar scintigraphy and US in SHPT based on lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Since 99m Tc-MIBI SPECT/CT shows advantages in preoperative localization and anatomical depiction, its application is currently increasing in popularity [14,15]. On 99m Tc-MIBI SPECT/CT images, the size, accurate location, density and adjacent tissues of the lesions can be observed.…”

Section: Introductionmentioning

confidence: 99%

The role of 99mTc-MIBI SPECT/CT in patients with secondary hyperparathyroidism: comparison with 99mTc-MIBI planar scintigraphy and ultrasonography

et al. 2020

View full text Add to dashboard Cite

Background This study aimed to compare the sensitivity of 99mTc-MIBI SPECT/CT, 99mTc-MIBI planar scintigraphy and ultrasonography (US) in patients with secondary hyperparathyroidism (SHPT), and to explore the factors that affect the sensitivity of 99mTc-MIBI SPECT/CT. Methods In this retrospective study, forty-six patients with SHPT who underwent 99mTc-MIBI planar scintigraphy, 99mTc-MIBI SPECT/CT and US were enrolled. They underwent surgery within 1 month. We compared the sensitivity of the different imaging methods based on the lesions according to the pathological results. The parathyroid lesions on 99mTc-MIBI SPECT/CT images were divided into missed diagnosis group (MDG) and non-missed diagnosis group (NMDG). We compared the lesion to background ratio (LBR), maximum diameter, volume, the mean CT Hounsfield unit values (CTmean) and location of lesions between MDG and NMDG. Results The sensitivity of 99mTc-MIBI SPECT/CT, 99mTc-MIBI planar scintigraphy and US were 70.30% versus 48.48% versus 61.82%, respectively. The sensitivity of 99mTc-MIBI SPECT/CT combined US was 79.39%, which was higher than 99mTc-MIBI SPECT/CT with significant difference (P = 0.000). On 99mTc-MIBI SPECT/CT images, the LBR, maximum diameter and volume of lesions in MDG was smaller than those in NMDG with significant difference (P < 0.001). The average LBR, maximum diameter and volume of lesions in MDG and NMDG were 3.42 ± 1.28, 9.32 ± 2.69 mm, 208.51 ± 163.22 mm3 versus 6.75 ± 5.08, 15.03 ± 4.94 mm and 863.85 ± 1216.0 mm3, respectively. Conclusions 99mTc-MIBI SPECT/CT exhibited the highest sensitivity among the three methods. When 99mTc-MIBI SPECT/CT combined with US, the sensitivity can be further improved. Lesions with lower MIBI uptake and smaller lesions on 99mTc-MIBI SPECT/CT images were easily missed.

show abstract

“…In a prospective clinical study, Sandqvist et al 2019 reported a statistically significant increase in PTA localisation sensitivity when contrast-enhanced CT image sets [A + V] were added to [S + N] [2]. Andersen et al 2018 found no differences in sensitivity between [S + N] and [S + N + V] [3]. Finally, Yeh et al 2019 showed no differences in diagnostic performance after adding [S] to a [N + A + V] image protocol [4].…”

Section: Introductionmentioning

confidence: 99%

The preoperative localisation of small parathyroid adenomas improves when adding Tc-99m-Sestamibi SPECT to multiphase contrast-enhanced CT

et al. 2021

View full text Add to dashboard Cite

Objectives To investigate the incremental value of Sestamibi SPECT combined with a non-enhanced and contrast-enhanced CT, using SPECT/CT, for the preoperative localisation of small parathyroid adenomas (PTA). Methods Retrospectively, 147 patients surgically cured from primary hyperparathyroidism, as verified by biochemistry 6 months postoperatively, were included. All patients had preoperatively undergone a dual time 99mTechnetium-Sestamibi SPECT (S) with multiphase CT including native (N), arterial (A) and venous (V) phases. Independently, two radiologists blinded from both the surgical and the preoperative imaging reports, sequentially performed PTA localisation starting with either [A] or [V], thereafter [A + N] or [V + N] and finally with the complete [A + N + S] or [V + N + S]. PTA localisation was reported for each image-set. The readers results were combined and the diagnostic performance for each image set was determined. Sensitivity was also calculated for the different quartiles of PTA weight distribution. Results The median adenoma weight was 315 mg. No statistically significant differences in diagnostic performance between arterial and venous based image sets were found. The net effect of adding [N] was to increase specificity. Sestamibi SPECT significantly increased the overall diagnostic accuracy for arterial- and venous-based image sets, p = 0.0008 and p = 0.001, respectively. [A + N + S] was found to have the highest diagnostic performance with 86.5% sensitivity and 94.9% overall accuracy. [A + N + S] was particularly advantageous for locating PTA in the lower weight quartiles. Conclusions Native CT-phase and dual time point Sestamibi SPECT increase specificity and sensitivity, respectively. These, in combination with a single contrast-enhanced CT-phase is the most optimal examination protocol for preoperative localisation of PTA using SPECT/CT.

show abstract

Contrast-enhanced computed tomography does not improve the diagnostic value of parathyroid dual-phase MIBI SPECT/CT

Abstract: Late CE-CT, compared with late LD-CT, did not significantly improve the sensitivity of dual-phase Tc-99m MIBI parathyroid SPECT/CT in a population of patients with primary hyperparathyroidism. These findings were consistent regardless of the size, location, or histology of the adenomas.

Cited by 5 publications

References 13 publications

Factors That Affect the Sensitivity of Imaging Modalities in Primary Hyperparathyroidism

Factors That Affect the Sensitivity of Imaging Modalities in Primary Hyperparathyroidism

The role of 99mTc-MIBI SPECT/CT in patients with secondary hyperparathyroidism: comparison with 99mTc-MIBI planar scintigraphy and ultrasonography

The preoperative localisation of small parathyroid adenomas improves when adding Tc-99m-Sestamibi SPECT to multiphase contrast-enhanced CT

Contact Info

Product

Resources

About