scholarly journals The role of 99mTc-MIBI SPECT-CT in reoperation therapy of persistent hyperparathyroidism patients

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Lijie Yin ◽  
Dandan Guo ◽  
Jie Liu ◽  
Jue Yan
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Effective Treatment ◽  
Surgical Resection ◽  
Ct Imaging ◽  
Ct Image ◽  
Planar Image ◽  
Persistent Hyperparathyroidism ◽  
99Mtc Mibi ◽  
Mibi Spect

AbstractTo compare the role of 99mTc-MIBI SPECT-CT image and US in reoperation of persistent secondary hyperparathyroidism patients. A total of 8 persistent secondary hyperparathyroidism patients underwent parathyroidectomy. The sensitivity and accuracy of US and 99mTc-MIBI images before operation were determined. 9 of 14 surgical resection tissues from 8 persistent secondary hyperparathyroidism patients were confirmed to parathyroid hyperplasia. The results showed that the sensitivities were 77.8% and 100%, respectively, for US and 99mTc-MIBI SPECT-CT images. And the accuracies of US and 99mTc-MIBI dual time planar image and SPECT-CT were 50%, 78.6%, respectively. There was significantly difference between two procedures (P=0.021). The superior and inferior localization of glands were both detected by the ultrasound and scintigraphy. Two ectopic parathyroidism nodules were found by 99mTc- MIBI SPECT-CT imaging, while US provided no consistent findings. There was no significantly difference between two procedures (P=0.3). Although two cases of them were not confirmed by pathology, the iPTH of them (800 and 1429 respectively) were much higher than other four cases (<400) pg/ml. PTX is a safe and effective treatment for the patients with persistent SHPT. 99mTc-MIBI planar and SPECT-CT imaging may provide more helps for clinician’s localization the hyperparathyroidism glands accurately.

scholarly journals The role of selective venous sampling in the management of persistent hyperparathyroidism revisited

2010 ◽  
Vol 163 (6) ◽  
pp. 945-952 ◽  
Author(s):  
Janneke E Witteveen ◽  
Job Kievit ◽  
Arian R van Erkel ◽  
Hans Morreau ◽  
Johannes A Romijn ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Venous Sampling ◽  
Selective Venous Sampling ◽  
Persistent Hyperparathyroidism ◽  
Recurrent Hyperparathyroidism ◽  
Mibi Spect

IntroductionLocalization studies are mandatory prior to revision surgery in patients with persistent hyperparathyroidism in order to improve surgical outcome and reduce the risk of lengthy explorations. However, in this case, noninvasive localization studies are reported to have a poor sensitivity. The aim of our study is to determine the accuracy of selective venous sampling (SVS) for parathyroid hormone (PTH) in localizing residual hyperactive parathyroid glands in patients with persistent or recurrent hyperparathyroidism.Patients and methodsWe retrospectively evaluated the localizing accuracy of 20 PTH SVS performed prior to revision surgery in 18 patients with persistent or recurrent primary hyperparathyroidism (n=11) or autonomous (tertiary) hyperparathyroidism (n=7). Tc99m-methoxy-isobutyle-isonitrile (MIBI)-single photon emission computed tomography (SPECT) was also performed in all patients prior to revision surgery. Operative and pathological data were obtained from hospital records.ResultsThe SVS was able to accurately localize 15 of the 20 pathological glands removed at revision surgery, representing a sensitivity of 75%. This sensitivity is significantly higher than that of Tc99m-MIBI-SPECT, which was only 30% (P=0.012).ConclusionOur findings demonstrate that SVS is a valuable localization study in patients with persistent or recurrent hyperparathyroidism, with a sensitivity significantly higher than that of Tc99m-MIBI-SPECT. Our data suggest that SVS represents a useful addition to the preoperative workup of these patients prior to revision surgery.

scholarly journals The key role of 99mTc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report

2015 ◽  
Vol 59 (3) ◽  
pp. 265-269 ◽  
Author(s):  
Qing Li ◽  
Jiemin Pan ◽  
Quanyong Luo ◽  
Yan Wang ◽  
Yuqian Bao ◽  
...  
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
99Mtc Mibi ◽  
Mibi Spect

scholarly journals Superior mediastinal typical carcinoid detected by 99mTc-MIBI SPECT/CT imaging

Medicine ◽  
2017 ◽  
Vol 96 (52) ◽  
pp. e9457
Author(s):  
Chenghui Lu ◽  
Zenghua Wang ◽  
Guoqiang Wang ◽  
Xufu Wang ◽  
Xinfeng Liu
Keyword(s):  
Ct Imaging ◽  
Typical Carcinoid ◽  
99Mtc Mibi ◽  
Mibi Spect

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

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shu-Qin Jiang ◽  
Ting Yang ◽  
Qiong Zou ◽  
Lei Xu ◽  
Ting Ye ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Hounsfield Unit ◽  
Ct Images ◽  
Maximum Diameter ◽  
Planar Scintigraphy ◽  
Diagnosis Group ◽  
Significant Difference ◽  
Missed Diagnosis ◽  
99Mtc Mibi ◽  
Mibi Spect

Abstract 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.

scholarly journals Diagnostic performance of ultrasonography, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in preoperative parathyroid gland localization in secondary hyperparathyroidism

2020 ◽  
Author(s):  
Rongqin Zhang ◽  
Zhanwen Zhang ◽  
Pinbo Huang ◽  
Zhi Li ◽  
Rui Hu ◽  
...  
Keyword(s):  
Secondary Hyperparathyroidism ◽  
Diagnostic Performance ◽  
Serum Alkaline Phosphatase ◽  
Parathyroid Glands ◽  
Dual Phase ◽  
Spearman Correlation ◽  
99Mtc Mibi ◽  
Mibi Scintigraphy ◽  
Mibi Spect ◽  
Higher Sensitivity

Abstract Background: Secondary hyperparathyroidism (SHPT) usually requires parathyroidectomy when drug regimens fail. However, obtaining an exact preoperative map of the locations of the parathyroid glands is a challenge. The purpose of this study was to compare the diagnostic performance of US, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT in patients with SHPT.Methods: Sixty patients with SHPT who were undergoing dialysis were evaluated preoperatively by US, dual-phase 99mTc-MIBI scintigraphy, early and delayed 99mTc-MIBI SPECT/CT. Postoperative pathology served as the gold standard. The sensitivity, specificity, and accuracy were determined for each method. Spearman correlation analysis was used to analyse the correlation of hyperplastic parathyroid calcification with serum alkaline phosphatase (ALP) and parathyroid hormone (PTH).Results: A total of 229 lesions in 60 patients were pathologically confirmed to be parathyroid hyperplasia, with 209 lesions in typical sites, 15 lesions in the upper mediastinum and 5 lesions in the thyroid. A total of 88.33% (53/60) of patients had four lesions. US, early and delayed 99mTc-MIBI SPECT/CT had significantly higher sensitivity and accuracy than dual-phase 99mTc-MIBI scintigraphy (P < 0.001). Furthermore, early 99mTc-MIBI SPECT/CT had significantly higher sensitivity (P < 0.001) and accuracy (P = 0.001 and P < 0.001) than US and delayed 99mTc-MIBI SPECT/CT. In patients with ectopic hyperplastic parathyroid glands, the sensitivity of early 99mTc-MIBI SPECT/CT (90%) was significantly higher than that of US (55%) and dual-phase 99mTc-MIBI scintigraphy (50%) (P < 0.05). The Spearman correlation results showed a significant linear association between calcification and both serum PTH and ALP (P = 0.002).Conclusion: The ability of early 99mTc-MIBI SPECT/CT to detect hyperplastic parathyroid glands in patients with SHPT is superior to that of US, dual-phase 99mTc-MIBI scintigraphy and delayed 99mTc-MIBI SPECT/CT; furthermore, dual-phase 99mTc-MIBI SPECT/CT is not essential.

Sign in / Sign up

Export Citation Format

Share Document