双相锝-99m MIBI甲状旁腺闪烁扫描中附加的侧针孔和SPECT/CT成像对原发性甲状旁腺功能亢进症患者甲状旁腺病变定位的疗效:单机构经验。

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-11-08 DOI:10.1097/MNM.0000000000001924
Selin Kesim, Halil Turgut Turoglu, Tuncay Kotan, Zeynep Ceren Balaban Genc, Khanim Niftaliyeva, Hasan Toper, Dilek Gogas Yavuz, Salih Ozguven, Handan Kaya, Fuat Dede, Mustafa Umit Ugurlu, Kevser Oksuzoglu, Feyza Cagliyan, Bahadir Mahmut Gulluoglu, Tunc Ones, Tanju Yusuf Erdil
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引用次数: 0

摘要

目的:使用双相锝-99m甲氧基异丁酰氮腈(Tc-99m MIBI)闪烁扫描进行甲状旁腺成像是识别原发性甲状旁腺功能亢进症(PHPT)患者甲状旁腺功能亢进的重要先决条件,有助于成功实施甲状旁腺靶向切除术。本研究旨在评估附加侧位成像和单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)与传统平面成像在确定PHPT患者甲状旁腺病变位置方面的临床价值:对105例接受了双相Tc-99m MIBI闪烁扫描并通过甲状旁腺切除术进行手术治疗的患者进行了回顾性研究。双相锝-99m-MIBI平面闪烁扫描附加侧针孔切面和SPECT/CT成像是按照科室方案进行的常规检查。通过以患者为基础的分析进行了成像模式之间的比较研究,并将闪烁成像结果与临床发现、生化标记物和组织病理学结果进行了比较:结果:前平面双相锝-99m MIBI闪烁扫描的敏感性和特异性分别为78.8%和80%。相比之下,侧面针孔扫描和 SPECT/CT 的敏感性分别为 85.9% 和 90.9%,特异性相同。正常钙血症和多腺疾病患者的敏感性降低。真阳性研究的腺瘤平均重量和大小明显高于假阴性或假阳性研究:结论:SPECT/CT为PHPT患者术前识别甲状旁腺病变提供了最高的诊断准确性。侧针孔成像的灵敏度相当,在无法使用SPECT/CT时可帮助腺瘤定位。
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Efficacy of additional lateral pinhole and SPECT/CT imaging in dual-phase Tc-99m MIBI parathyroid scintigraphy for localising parathyroid pathologies in patients with primary hyperparathyroidism: a single-institution experience.

Purpose: Parathyroid imaging with dual-phase technetium-99m methoxyisobutrylizonitrile (Tc-99m MIBI) scintigraphy serves as an important prerequisite for the identification of hyperfunctioning parathyroid gland(s) in patients with primary hyperparathyroidism (PHPT) for a successful targeted parathyroidectomy. This study aimed to evaluate the clinical value of additional lateral imaging and single-photon emission computed tomography/computed tomography (SPECT/CT) versus conventional planar imaging for locating parathyroid pathologies in patients with PHPT.

Materials and methods: A retrospective review was performed on 105 patients who underwent dual-phase Tc-99m MIBI scintigraphy and were surgically treated by parathyroidectomy. Dual-phase Tc-99m-MIBI planar scintigraphy with additional lateral pinhole views and SPECT/CT imaging was performed on a routine basis, as per departmental protocol. Comparison study between imaging modalities was done by patient-based analysis and scintigraphy results were compared with the clinical findings, biochemical markers, and histopathological findings.

Results: Sensitivity and specificity for anterior planar dual-phase Tc-99m MIBI scintigraphy were 78.8 and 80%, respectively. In comparison, lateral pinhole scan and SPECT/CT alone were found to have sensitivities of 85.9 and 90.9%, respectively, with the same specificity. Sensitivity decreased in patients with normocalcaemia and multiglandular disease. The mean adenoma weight and size for true-positive studies were significantly higher than those for false-negative or false-positive studies.

Conclusion: SPECT/CT provided the highest diagnostic accuracy for preoperative identification of parathyroid lesions in PHPT patients. Lateral pinhole imaging offers comparable sensitivity and aids in adenoma localisation when SPECT/CT is unavailable.

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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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