open access

Vol 21, No 1 (2018)
Original articles
Published online: 2017-09-25
Submitted: 2017-07-25
Accepted: 2017-09-19
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Diagnostic accuracy of planar, SPECT, and SPECT/CT parathyroid scintigraphy protocols in patients with hyperparathyroidism

Yutapong Raruenrom, Daris Theerakulpisut, Nantaporn Wongsurawat, Charoonsak Somboonporn
DOI: 10.5603/NMR.a2018.0003
·
Pubmed: 29319134
·
Nucl. Med. Rev 2018;21(1):20-25.

open access

Vol 21, No 1 (2018)
Original articles
Published online: 2017-09-25
Submitted: 2017-07-25
Accepted: 2017-09-19

Abstract

BACKGROUND

Several parathyroid scintigraphy protocols have been used for preoperative localization of hyperfunctioning parathyroid glands in patients with hyperparathyroidism. The aim of this study is to compare the diagnostic accuracy of various parathyroid scintigraphy protocols.

MATERIAL AND METHODS

A retrospective diagnostic accuracy study with histopathology as the reference standard was done. Five imaging protocols were investigated including planar dual tracer Tc-99m pertechnetate/Tc-99m sestamibi (DT), planar dual phase Tc-99m sestamibi (DP), and combined dual tracer dual phase (DTDP) protocols, as well as add-on single photon emission computed tomography (SPECT), and single photon emission computed tomography/computed tomography (SPECT/CT).

RESULTS

A total of 63 patients underwent parathyroid scintigraphy and subsequent parathyroid surgery with a total of 106 excised lesions with histopathological diagnosis. On a lesion-based analysis, sensitivity and specificity (with 95% confidence interval) of protocols were as follows. DT protocol: 69.4% (53.1–82.0%) and 80.0% (49.0–94.3%); DP protocol: 78.6% (52.4–92.4%) and 33.3% (9.7–70.0%); DTDP protocol: 64.7% (47.9–78.5%) and 50.0% (18.8–81.2%); SPECT: 92.3% (66.7–98.6%) and 75.0% (30.1–95.4%); SPECT/CT: 80.0% (49.0–94.3%) and 75.0% (30.1–95.4%). All protocols had perfect sensitivity for detection of parathyroid adenoma whereas SPECT was the most sensitive method for detection of hyperplastic parathyroid glands.

CONCLUSION

Planar parathyroid scintigraphy using the DT protocol has a trend towards being more accurate than DP and DTDP protocols. Additional imaging with SPECT and SPECT/CT had a trend towards being more accurate than planar imaging.

Abstract

BACKGROUND

Several parathyroid scintigraphy protocols have been used for preoperative localization of hyperfunctioning parathyroid glands in patients with hyperparathyroidism. The aim of this study is to compare the diagnostic accuracy of various parathyroid scintigraphy protocols.

MATERIAL AND METHODS

A retrospective diagnostic accuracy study with histopathology as the reference standard was done. Five imaging protocols were investigated including planar dual tracer Tc-99m pertechnetate/Tc-99m sestamibi (DT), planar dual phase Tc-99m sestamibi (DP), and combined dual tracer dual phase (DTDP) protocols, as well as add-on single photon emission computed tomography (SPECT), and single photon emission computed tomography/computed tomography (SPECT/CT).

RESULTS

A total of 63 patients underwent parathyroid scintigraphy and subsequent parathyroid surgery with a total of 106 excised lesions with histopathological diagnosis. On a lesion-based analysis, sensitivity and specificity (with 95% confidence interval) of protocols were as follows. DT protocol: 69.4% (53.1–82.0%) and 80.0% (49.0–94.3%); DP protocol: 78.6% (52.4–92.4%) and 33.3% (9.7–70.0%); DTDP protocol: 64.7% (47.9–78.5%) and 50.0% (18.8–81.2%); SPECT: 92.3% (66.7–98.6%) and 75.0% (30.1–95.4%); SPECT/CT: 80.0% (49.0–94.3%) and 75.0% (30.1–95.4%). All protocols had perfect sensitivity for detection of parathyroid adenoma whereas SPECT was the most sensitive method for detection of hyperplastic parathyroid glands.

CONCLUSION

Planar parathyroid scintigraphy using the DT protocol has a trend towards being more accurate than DP and DTDP protocols. Additional imaging with SPECT and SPECT/CT had a trend towards being more accurate than planar imaging.

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Keywords

radionuclide imaging; parathyroid scintigraphy; SPECT; SPECT/CT; parathyroid glands; hyperparathyroidism

About this article
Title

Diagnostic accuracy of planar, SPECT, and SPECT/CT parathyroid scintigraphy protocols in patients with hyperparathyroidism

Journal

Nuclear Medicine Review

Issue

Vol 21, No 1 (2018)

Pages

20-25

Published online

2017-09-25

DOI

10.5603/NMR.a2018.0003

Pubmed

29319134

Bibliographic record

Nucl. Med. Rev 2018;21(1):20-25.

Keywords

radionuclide imaging
parathyroid scintigraphy
SPECT
SPECT/CT
parathyroid glands
hyperparathyroidism

Authors

Yutapong Raruenrom
Daris Theerakulpisut
Nantaporn Wongsurawat
Charoonsak Somboonporn

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