Presurgical localization of abnormal parathyroid glands using a single injection of Tc-99m sestamibi: comparison of high-resolution parallel-hole and pinhole collimators, and interobserver and intraobserver variation

Clinical Nuclear Medicine
Anne Kirstine ArveschougBirthe Vammen

Abstract

Scintigraphy using Tc-99m sestamibi is sensitive in localizing abnormal parathyroid glands in patients with hyperparathyroid disease (HPT). Various methods have been described to increase the sensitivity of the single-tracer technique, such as SPECT, factor analysis of dynamic structures, and use of a pinhole collimator, but often the gain in sensitivity is accompanied by a loss of specificity. In this study, the authors compared the sensitivity and specificity of side localization of the diseased gland(s) using the double-phase single-tracer method performed with and without the addition of a pinhole collimator in the early and late phases of imaging. The combined high-resolution parallel-hole and pinhole collimator imaging protocol was further validated by investigation of interobserver and intraobserver variation. Forty-seven patients with primary HPT and 16 patients with secondary HPT examined from 1996 to 1999 with the Tc-99m sestamibi double-phase technique and who had subsequent surgery formed the basis of the study. Their histologic and follow-up data were also factored into this analysis. Tc-99m sestamibi (750 to 900 MBq; 18.9 to 24.3 mCi) was injected. Ten-minute neck and mediastinum images acquiring 1,000 K counts we...Continue Reading

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Citations

Oct 26, 2007·European Journal of Nuclear Medicine and Molecular Imaging·Thomas CarlierCatherine Ansquer
Jan 5, 2013·Annals of Nuclear Medicine·Yusuke HigakiKeiichi Kawai
Aug 31, 2010·Behaviour & Information Technology·Enid N H MontagueBrian M Kleiner
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Jan 28, 2003·Nuclear Medicine Communications·M J O'Doherty, A G Kettle
Apr 30, 2003·Nuclear Medicine Communications·Lluís Bernà, Antonio Sitges-Serra

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