The utility of 99mTc-sestamibi scintigraphy in the localisation of parathyroid adenomas in primary hyperparathyroidism

Glynn, Nigel; Lynn, N.; Donagh, Carol; Crowley, Rachel; Smith, Diarmuid; Thompson, C.J.; Hill, A. D. K.; Keeling, F.; Agha, Amar

doi:10.1007/s11845-010-0641-9

Cited by 12 publications

(12 citation statements)

References 17 publications

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“…Thirteen studies were prospective [10][11][12][16][17][18][19][20][21][22][23][24][25] and 15 were retrospective. 4,5,[26][27][28][29][30][31][32][33][34][35][36][37][38] Levels of evidence analysis were determined to be level III (cohort studies) and V (case series). The main concerns regarding study quality were: minor variations in patient inclusion criteria, potential bias in patient selection inherent to retrospective studies, and heterogeneity in the reporting of data and summary statistics.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…4,5,[10][11][12]17,19,20,22,23,30,31 Dual-phase 99m Tc-sestamibi (MIBI) was assessed in 13 studies. 4,10,11,[19][20][21]24,[28][29][30]32,37,38 Based on 11 studies, 4,10,11,19,20,22,24,28,31,32,38 MIBI had a pooled sensitivity of 0.76 (95% CI 0.71-0.80) and PPV of 0.86 (95% CI 0.82-0.90). Interestingly, some of these studies (n 5 10) also included comparative cohorts without concurrent thyroid pathology showing sensitivity of MIBI ranging from 0.63 to 1.00 and PPV from 0.92 to 1.00.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

“…Interestingly, some of these studies (n 5 10) also included comparative cohorts without concurrent thyroid pathology showing sensitivity of MIBI ranging from 0.63 to 1.00 and PPV from 0.92 to 1.00. 4,5,10,19,20,22,[28][29][30]32,38 Combined ultrasound and scintigraphy was investigated in 7 studies. 4,10,12,19,20,24,36 Six studies evaluated ultrasound with dual-phase sestamibi (MIBI), 4,10,19,20,25,36 1 study evaluated ultrasound with MIBI/pertechnetate subtraction, 5 and another evaluated ultrasound with either MIBI (n 5 27) or MIBI/pertechnetate subtraction (n 5 50).…”

Section: Imaging Modalitiesmentioning

confidence: 99%

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Preoperative imaging for parathyroid localization in patients with concurrent thyroid disease: A systematic review

et al. 2018

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Section: Quality Of Included Studiesmentioning

confidence: 99%

Section: Imaging Modalitiesmentioning

confidence: 99%

Section: Imaging Modalitiesmentioning

confidence: 99%

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Preoperative imaging for parathyroid localization in patients with concurrent thyroid disease: A systematic review

et al. 2018

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“…Approximately 80% of cases of this disease are a result of a solitary parathyroid adenoma. The success rate in surgical treatment is high on condition that localisation diagnostics are accurate [1].…”

Section: Maria Henryka Listewnik Et Al Semi-quantitative Parathyroimentioning

confidence: 99%

Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study

et al. 2017

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BBACKGROUND:The aim of this paper was to analyse our own semi-quantitative method of assessing focal lesions localised in pre-operative diagnostic scintigraphy of primary hyperparathyroidism (PHPT) using 99m Tc-MIBI with washout and comparing these data with the result of the histopathological examination (HP). MATERIAL AND METHODS:A total of 40 (37 female, 3 male, average age 58.7 years) patients with a suspicion of PHPT were enrolled for prospective analysis. Dual phase planar and SPECT/CT examination with 99m Tc-MIBI were performed. The tumour to background ratios in the 10 th and 120 th minute were calculated (TBR10 and TBR120) on the basis of the planar acquisition.PTH, ionised calcium and phosphate levels were measured.Parathyroid surgery alone or combined with subtotal/total thyreoidectomy was conducted in 23 (57.5%) and 17 (42.5%) patients, respectively. A HP was performed in all patients. RESULTS:Average concentration of PTH in the whole group was 243.95 pg/ml. There was a statistically significant correlation between medians of PTH concentration and parathyroid histopathological results (p = 0.01). A total of 45 lesions of increased uptake were found in 32 (80.0%) and 34 (85%) patients in the early phase and the delayed phase, respectively.The post-operative material contained 20 (44.5%) parathyroid adenomas, 11 (24.5%) cases of hyperplasia, 2 (4.4%) cancers, 4 (8.9%) cases of normal parathyroid tissue, 2 (4.4%) lymph nodes and 6 (13.3%) cases of thyroid gland tissue.The medians of TBR10 and TBR120 for lesions examined in the HP were respectively: 3.64 and 2.59 for adenoma; 3.08 and 2.18 for hyperplasia; 7.7 and 5.5 for parathyroid cancer, 4.89 and 3.16 for normal tissue and 5.26 and 2.95 for lymph nodes or thyroid gland tissue.A high correlation coefficient of TBR10 to TBR120 in the parathyroid adenoma and parathyroid hyperplasia groups was observed with r = 0.867 and r = 0.964, respectively. The ρr correlation coefficient of TBR10 to TBR120 for normal parathyroid was 0.4.There was a statistically significant association between the HP and TBR10 medians (p = 0.047), but not between histopathology and TBR120 medians (p = 0.840

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“…Reported sensitivity of planar scintigraphy is 69-90 % (16,17,18,19) with the positive predictive value 97.8 % in patients without thyroid pathology (10). SPECT is a more advanced method with sensitivity 78.9-96 % and the positive predictive value 90.7 % (12,13,20).…”

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confidence: 99%

Primary hyperparathyreosis: Is concordant sonography and scintigraphy really so important?

Gergel¹,

Brychta²,

Vician³

et al. 2014

BLL

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Abstract:Background: In primary hyperparathyreosis, US and scintigraphy are the most usual preoperative localization methods for detection of parathyroid adenomas or hyperplasia. Results: 88 (80 female) patients were detected. Unilateral neck exploration was performed in 43 patients (48.9 %) and bilateral exploration in 45 patients (51.1 %). The cure rate was 97.6 %. None case of parathyroid hyperplasia was detected, there were 2 cases of duplex adenoma. For left/right and quadrant localization, sensitivity of US was 71.05 % and 55.07 %, of scintigraphy 95.77 % and 88.71 %, and in concordant imaging 97.67 % and 96.77 %. Analogically, PPV was: US 91.53 % and 76.00 %, scintigraphy 87.18 % and 74.32 %, concordant imaging 93.33 % and 81.08 %. Only US sensitivity was signifi cantly lower, all other differences showed no statistical signifi cance. Conclusion: Our data showed low sensitivity but a high positive predictive value of ultrasonography and a high diagnostic value of scintigraphy. Sensitivity and the positive predictive value of concordant localization showed no signifi cant difference, compared to scintigraphy. The routine need for concordance for parathyroid adenoma localization appears dubious, however, its value for prediction of multiglandular disease remains important for protocols that do not apply peroperative localization (Tab. 2, Ref. 35 Acknowledgments: This text is an original work based upon authors' experience and data. The text and none of its parts has never been published before.

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The utility of 99mTc-sestamibi scintigraphy in the localisation of parathyroid adenomas in primary hyperparathyroidism

Abstract: Sestamibi scintigraphy was more likely to be positive in younger patients without nodular thyroid disease who have larger parathyroid adenomas with more severe hyperparathyroidism.

Cited by 12 publications

References 17 publications

Preoperative imaging for parathyroid localization in patients with concurrent thyroid disease: A systematic review

Preoperative imaging for parathyroid localization in patients with concurrent thyroid disease: A systematic review

Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study

Primary hyperparathyreosis: Is concordant sonography and scintigraphy really so important?

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