The efficacy of sestamibi parathyroid scintigraphy for directing surgical approaches based on modified interpretation criteria

Clinical Nuclear Medicine
Chun K KimWilliam B Inabnet

Abstract

With the increasing use of targeted parathyroidectomy, the accuracy of sestamibi parathyroid scintigraphy (SPS) in determining the best surgical approach has become more clinically relevant than its sensitivity for detecting all abnormal glands. The reported accuracy of SPS does not represent the true efficacy of SPS for directing targeted parathyroidectomy, because many authors reported accuracy on the basis of abnormal glands. The authors assessed the efficacy of SPS based on modified interpretation criteria to determine specifically whether SPS influences the surgeon's choice of a targeted versus a conventional approach to parathyroidectomy. The authors reviewed the SPS studies (both dual-isotope subtraction and Tc-99m sestamibi dual-phase techniques) performed in 80 patients with primary hyperparathyroidism. All patients had surgery with histologic diagnoses, intraoperative PTH assays, and clinical follow-up. Of 75 patients with solitary adenomas, 9 SPS studies were negative, equivocal, or showed two or more foci, and 66 studies showed a solitary focus on the correct side. Of these 66 studies, 63 showed a lesion in the correct quadrant (e.g., superior or inferior) and 3 predicted the correct side only but a wrong quadrant. ...Continue Reading

Citations

Dec 20, 2003·Current Opinion in Oncology·Göran Akerström, Per Hellman
Jun 21, 2005·Clinical Nuclear Medicine·Bheerendra Prasad, Richard Michael Fleming
May 23, 2006·Clinical Nuclear Medicine·Sang Yoon OhChun K Kim
Dec 17, 2008·World Journal of Surgery·Linwah YipJennifer B Ogilvie
Oct 18, 2005·American Journal of Surgery·Gavin T SlittRobert A Kozol
Feb 1, 2015·European Journal of Endocrinology·Carole GuerinDavid Taïeb
Mar 5, 2005·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·James M RudaBrendan C Stack

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