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99mTc-Sestamibi/123I Subtraction SPECT/CT in Parathyroid Scintigraphy: Is Additional Pinhole Imaging Useful?

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Details

Original languageEnglish
Article number2712018
JournalInternational Journal of Molecular Imaging
Volume2017
DOIs
Publication statusPublished - 18 Oct 2017
Publication typeA1 Journal article-refereed

Abstract

Objectives: This retrospective study evaluated whether the use of additional anterior 99mTc-sestamibi/123I pinhole imaging improves the outcome of 99mTc-sestamibi/123I subtraction SPECT/CT in parathyroid scintigraphy (PS).

Materials and Methods: PS using simultaneous dual-isotope subtraction methods and an acquisition protocol combining SPECT/CT and planar pinhole imaging was performed for 175 patients with primary or secondary hyperparathyroidism. All patients who proceeded to surgery with complete postsurgery laboratory findings were included in this study (n = 94). SPECT/CT images alone and combined with pinhole images were evaluated.

Results: There were 111 enlarged parathyroid glands of which 104 and 108 glands were correctly visualized by SPECT/CT (seven false positives) or SPECT/CT with pinhole (three false positives), respectively. Both sensitivity and specificity were higher with combined SPECT/CT with pinhole than with SPECT/CT alone (97% versus 94% and 99% versus 98%, resp., not significant). The false-positive rate was 6% with SPECT/CT and decreased to 3% using combined SPECT/CT with pinhole.

Conclusion: 99mTc-sestamibi/123I subtraction SPECT/CT is a highly sensitive and specific protocol for PS. The use of additional anterior pinhole imaging increases both sensitivity and specificity of PS, although this increase is not statistically significant.

Keywords

  • Journal Article

Publication forum classification

Field of science, Statistics Finland