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Clinical Utility of Tc-99m MIBI SPECT/CT for Preoperative Localization of Parathyroid Lesions

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Abstract

We aimed to demonstrate the role of SPECT/CT in preoperative localization of parathyroid lesions in patients with hyperparathyroidism who had technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) dual-phase parathyroid scintigraphy. We evaluated retrospectively the scintigraphic data of 103 patients who had parathyroidectomy after Tc-99m MIBI dual-phase parathyroid scintigraphy with SPECT/CT. The planar and SPECT/CT images were evaluated separately to determine their efficacy in localizing parathyroid lesions. These results were then compared with surgical data. There were 84 female and 19 male patients whose mean age was 54 ± 12 years. A total of 115 parathyroid lesions in 103 patients were resected during operations. In 87 patients, with both planar and SPECT/CT images, a total of 100 lesions could be detected correctly. In 11 patients, only SPECT/CT images could show 13 subcentimetric lesions. In three patients, three lesions were evaluated as parathyroid lesions both with planar and SPECT/CT images, but according to histopathologic evaluation, they came out to be nonparathyroidal lesions. In two patients, two parathyroid lesions could not be detected preoperatively neither with planar nor with SPECT/CT images. The lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 87 %, 99 %, 97.1 %, 95.3 %, and 95.8 % for planar images and 98.3 %, 99 %, 97.4 %, 99.4 %, and 98.8 % for SPECT/CT images, respectively. Tc-99m MIBI parathyroid scintigraphy should be a diagnostic modality of choice in preoperative evaluation of patients with hyperparathyroidism. SPECT/CT has an incremental value both in demonstrating subcentimetric lesions and in accurately localizing lesions anatomically.

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Authors and Affiliations

  1. Istanbul Medical Faculty, Nuclear Medicine Department, Istanbul University, Millet Cad, 34390, Capa-Fatih, Istanbul, Turkey

    Zeynep Gozde Ozkan, Seher Nilgun Unal, Serkan Kuyumcu, Yasemin Sanli & Mehmet Fatih Gecer

  2. Istanbul Medical Faculty, General Surgery Department, Istanbul University, Millet Cad, 34390, Capa-Fatih, Istanbul, Turkey

    Beyza Ozcinar, Yasemin Senyurek Giles & Yesim Erbil

Authors
  1. Zeynep Gozde Ozkan
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  2. Seher Nilgun Unal
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  3. Serkan Kuyumcu
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  4. Yasemin Sanli
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  5. Mehmet Fatih Gecer
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  6. Beyza Ozcinar
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  7. Yasemin Senyurek Giles
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  8. Yesim Erbil
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Correspondence to Zeynep Gozde Ozkan.

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The authors declare that they have no conflict of interest.

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Our research has not been funded by any organization.

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Informed consent was obtained from all individual participants included in the study.

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Our study is retrospectively designed. For this type of study, formal consent is not required.

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Ozkan, Z.G., Unal, S.N., Kuyumcu, S. et al. Clinical Utility of Tc-99m MIBI SPECT/CT for Preoperative Localization of Parathyroid Lesions. Indian J Surg 79, 312–318 (2017). https://doi.org/10.1007/s12262-016-1489-7

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  • DOI: https://doi.org/10.1007/s12262-016-1489-7

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