Role of SPECT and SPECT/CT in the Surgical Treatment of Primary Hyperparathyroidism

Taubman, Michele L.; Goldfarb, Melanie; Lew, John I.

doi:10.1155/2011/141593

Cited by 33 publications

(37 citation statements)

References 31 publications

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“…Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting, affecting 2-3 of 500 women and 1 of 2000 men (211,212), with a peak incidence in the fourth and fifth decades of life (213). Diagnosis is based on elevated serum and ionized calcium levels with elevated or normal intact PTH levels in the presence of normal renal function (211).…”

Section: Parathyroid and Thyroid Scintigraphy With Spect/ctmentioning

confidence: 99%

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Endocrine Scintigraphy with Hybrid SPECT/CT

et al. 2014

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Nuclear medicine imaging of endocrine disorders takes advantage of unique cellular properties of endocrine organs and tissues that can be depicted by targeted radiopharmaceuticals. Detailed functional maps of biodistributions of radiopharmaceutical uptake can be displayed in three-dimensional tomographic formats, using single photon emission computed tomography (CT) that can now be directly combined with simultaneously acquired cross-sectional anatomic maps derived from CT. The integration of function depicted by scintigraphy and anatomy with CT has synergistically improved the efficacy of nuclear medicine imaging across a broad spectrum of clinical applications, which include some of the oldest imaging studies of endocrine dysfunction.

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Section: Parathyroid and Thyroid Scintigraphy With Spect/ctmentioning

confidence: 99%

“…Diagnosis is based on elevated serum and ionized calcium levels with elevated or normal intact PTH levels in the presence of normal renal function (211). Currently most patients diagnosed with hyperparathyroidism are asymptomatic as a result of widespread screening biochemical laboratory tests (211).…”

Section: Parathyroid and Thyroid Scintigraphy With Spect/ctmentioning

confidence: 99%

Endocrine Scintigraphy with Hybrid SPECT/CT

et al. 2014

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“…The positive predictive value of 96% when a MIBI-scan is showing unilateral uptake justifies this approach. The contemporary use of SPECT or SPECT/CT may further increase this percentage in the near future, but it is accompanied by an increase in costs and patient radiation doses [18].…”

Section: Discussionmentioning

confidence: 99%

“…While MIBI identifies a hyperfunctional parathyroid gland (PG), ultrasonography (US) and CT-scanning (CT) of the neck detect an enlarged PG. At present single-photon emission computed tomography (SPECT) and the fusion of SPECT and CT images (SPECT/CT) is gaining importance, combining qualities that aim to detect a physiological abnormality and determine its exact anatomical localization [18].…”

Section: Introductionmentioning

confidence: 99%

Additional Imaging Following a Negative Sestamibi Scan in Primary Hyperparathyroidism

Twigt¹,

Vollebregt²,

Hooge³

et al. 2012

IJOHNS

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Background: The objective of this study was to assess the additional yield of US and CT following a "negative" initial MIBI-scintigraphy (MIBI) in patients with primary hyperparathyroidism. Methods: Prospective data were collected regarding 100 consecutive patients, preferentially undergoing a minimally invasive parathyroidectomy (MIP). MIBI was the initial imaging study for localizing a solitary adenoma, followed by US and CT (US/CT) in "MIBI-negative"-patients. Results: Surgery led to normocalcemia in 98 patients (98%) after one operation. Overall 97 patients had solitary parathyroid disease while three patients had multiglandular disease. The sensitivity of imaging increased from 74% for MIBI alone to 92% following subsequent US/CT in "MIBI-negative"-patients. The positive predictive value of a "positive" MIBI was 96% and 76% of a positive US/CT following negative MIBI. The proportion of patients who underwent successful MIP increased from 60 to 72%. Conclusions: MIBI and the combination of US and CT are complementary imaging studies. Additional localization studies after a negative sestamibi scan enhances the number of patients with primary hyperparathyroidism profiting from a minimally invasive approach.

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“…pHPT is due to single gland disease in approximately 70-95% of cases, gland hyperplasia responsible for 15%, double adenoma 4% or rarely caused by parathyroid carcinoma [11,12].…”

Section: Introductionmentioning

confidence: 99%