Comparison between single-photon emission computed tomography/computed tomography and ultrasound in preoperative detection of parathyroid adenoma: Retrospective review of an institutional experience


Okudan B., Seven B., Coskun N., Albayrak A.

Nuclear Medicine Communications, vol.40, no.12, pp.1211-1215, 2019 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 12
  • Publication Date: 2019
  • Doi Number: 10.1097/mnm.0000000000001104
  • Journal Name: Nuclear Medicine Communications
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1211-1215
  • Keywords: 99m-methoxyisobutylisonitrile, hyperparathyroidism, minimally invasive parathyroidectomy, parathyroid adenoma, single-photon emission computed tomography/computed tomography, ultrasound
  • Ankara Yıldırım Beyazıt University Affiliated: No

Abstract

© 2019 Wolters Kluwer Health, Inc. All rights reserved.Objective The aim of this study was to evaluate the accuracy of technetium- 99m-methoxyisobutylisonitrile (99mTc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) and ultrasound in preoperative localization of single parathyroid adenomas (PTAs) in patients with primary hyperparathyroidism (pHPT) who would be suitable for minimally invasive parathyroidectomy (MIP). Methods A retrospective study of 143 consecutive patients with biochemical evidence of hyperparathyroidism who underwent preoperative localization of parathyroid lesions using 99mTc-MIBI SPECT/CT and ultrasound, and proceeded to parathyroid surgery at our institution from January 2013 to January 2018. Of these, 125 had single adenomas and are the subject of this study. The sensitivity, positive predictive value (PPV) and accuracy of the two imaging techniques for the accurately identification and lateralization of PTAs were determined using histopathology as the criterion standard. Results Of 125 PTAs, the correct identification and lateralization were significantly higher by SPECT/CT than ultrasound. SPECT/CT and ultrasound detected lesions with histopathologically proven PTAs in 116 and 95 patients, respectively. The sensitivity, PPV and accuracy were 92.17, 94.64 and 87.60%, respectively, for SPECT/CT and 75.89, 90.43 and 70.25%, respectively, for ultrasound in lateralization analysis. Conclusions The results of our study indicate that 99mTc-MIBI SPECT/CT is more accurate than ultrasound for the preoperative identification of single PTAs in patients with pHPT who are candidates for MIP.