Preoperative localization of parathyroid glands

2004 ◽  
Vol 43 (03) ◽  
pp. 85-90 ◽  
Author(s):  
E. Lopez Hänninen ◽  
Th. Steinmüller ◽  
T. Rohlfing ◽  
H. Bertram ◽  
M. Gutberlet ◽  
...  
Keyword(s):  
Image Fusion ◽  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Parathyroid Glands ◽  
Preoperative Localization ◽  
Mri Findings ◽  
99Mtc Mibi ◽  
Weighted Sequences ◽  
Mibi Scintigraphy

Summary Aim: Minimally invasive resection of hyperfunctional parathyroid glands is an alternative to open surgery. However, it requires a precise preoperative localization. This study evaluated the diagnostic use of magnetic resonance (MR) imaging, parathyroid scintigraphy, and consecutive image fusion. Patients, methods: 17 patients (9 women, 8 men; age: 29-72 years; mean: 51.2 years) with primary hyperparathyroidism were included. Examination by MRI used unenhanced T1- and T2-weighted sequences as well as contrast-enhanced T1-weighted sequences. 99mTc-MIBI scintigraphy consisted of planar and SPECT (single photon emission tomography) imaging techniques. In order to improve the anatomical localization of a scintigraphic focus, SPECT-data were fused with the corresponding MR-data using a modified version of the Express 5.0 software (Advanced Visual Systems, Waltham, MA). Results of image fusion were then compared to histopathology. Results: In 14/17 patients, a single parathyroid adenoma was found. There were 3 cases with hyperplastic glands. MRI detected 10 (71%), scintigraphy 12 (86%) adenomas. Both modalities detected 1/3 patients with hyperplasia. Image fusion improved the anatomical assignment of the 13 scintigraphic foci in five patients and was helpful in the interpretation of inconclusive MR-findings in two patients. Conclusions: Both MRI and 99mTc-MIBI scintigraphy sensitively detect parathyroid adenomas but are less reliable in case of hyperplastic glands. In case of a scintigraphic focus, image fusion considerably improves its topographic assignment. Furthermore, it facilitates the evaluation of inconclusive MRI findings.

scholarly journals PREOPERATIVE LOCALIZATION OF ENLARGED PARATHYROID GLANDS BY 99mTc-MIBI SCINTIGRAPHY

1997 ◽  
Vol 88 (9) ◽  
pp. 795-800 ◽  
Author(s):  
Nobumasa Fujimoto ◽  
Kiichiro Itoh ◽  
Hidehumi Kishikawa ◽  
Akira Tohda ◽  
Natsuki Takaha ◽  
...  
Keyword(s):  
Parathyroid Glands ◽  
Preoperative Localization ◽  
99Mtc Mibi ◽  
Mibi Scintigraphy

scholarly journals Parathyroidectomia: treatment of secondary hyperparathyroidism. Causes and prophylaxis of disease relapse

2011 ◽  
Vol 18 (4) ◽  
pp. 170-174
Author(s):  
V. BEIŠA ◽  
K. LAGUNAVIČIUS ◽  
A. BEIŠA ◽  
K. STRUPAS
Keyword(s):  
Parathyroid Hormone ◽  
Surgical Treatment ◽  
Secondary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Ultrasound Examination ◽  
Single Photon ◽  
Photon Emission ◽  
Parathyroid Glands ◽  
Emission Computed Tomography ◽  
Mibi Scintigraphy

Background. The growing number of haemodialysis patients and the increasing their life expectancy within the past few years have resulted in a rise of long-term haemodialysis-associated complications. The aim of the paper is to present a case study of a successful surgical treatment of secondary hyperthyroidism and assess the causes of the disease. Materials and methods. A 63-year-old male patient had been on haemodialysis for 18 years; he had undergone parathyroidectomy for secondary hyperparathyroidism 10 years ago. The relapse of the disease was suspected when the patient developed the onset of pruritus and muscle pain. The following tests were performed: biochemical markers of plasma calcium and parathyroid hormone, thyroid ultrasound examination, parathyroid gland 99 mTc MIBI scintigraphy, single photon emission computed tomography of the neck and mediastinum. Results. Elevated calcium (2.73 mmol/l serum) and parathyroid hormone (1352 pg/ml blood plasma) levels were found. Ultrasound examination, 99 mTc MIBI scintigraphy and SPECT revealed parathyroid adenoma of the left inferior thyroid section. The patient underwent surgery in 2011. Remnants of the previously resected parathyroid gland were removed, and an accessory parathyroid gland was found within the thymus; this gland was removed, and partial autotransplantation was performed. The level of the parathyroid hormone decreased to 24 pg/ml during the day after surgery. The histological examination of the removed tissues was performed. Conclusions. Accessory parathyroid glands are usually found within the thymus; therefore, any type of surgical treatment of secondary hyperparathyroidism should include thymectomy. Keywords: parathyroid glands, secondary hyperparathyroidism, haemodialysis, parathyroidectomy

scholarly journals Standardization of the [68Ga]Ga-PSMA-11 Radiolabeling Protocol in an Automatic Synthesis Module: Assessments for PET Imaging of Prostate Cancer

2021 ◽  
Vol 14 (5) ◽  
pp. 385
Author(s):  
Leonardo L. Fuscaldi ◽  
Danielle V. Sobral ◽  
Ana Claudia R. Durante ◽  
Fernanda F. Mendonça ◽  
Ana Cláudia C. Miranda ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pet Imaging ◽  
Saline Solution ◽  
Serum Proteins ◽  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Lncap Cells ◽  
Automatic Synthesis

Prostate-specific membrane antigen (PSMA) is a glycoprotein present in the prostate, that is overexpressed in prostate cancer (PCa). Recently, PSMA-directed radiopharmaceuticals have been developed, allowing the pinpointing of tumors with the Positron Emission Tomography (PET) or Single Photon Emission Computed Tomography (SPECT) imaging techniques. The aim of the present work was to standardize and validate an automatic synthesis module-based radiolabeling protocol for [68Ga]Ga-PSMA-11, as well as to produce a radiopharmaceutical for PET imaging of PCa malignancies. [68Ga]Ga-PSMA-11 was evaluated to determine the radiochemical purity (RCP), stability in saline solution and serum, lipophilicity, affinity to serum proteins, binding and internalization to lymph node carcinoma of the prostate (LNCaP) cells, and ex vivo biodistribution in mice. The radiopharmaceutical was produced with an RCP of 99.06 ± 0.10%, which was assessed with reversed-phase high-performance liquid chromatography (RP-HPLC). The product was stable in saline solution for up to 4 h (RCP > 98%) and in serum for up to 1 h (RCP > 95%). The lipophilicity was determined as −3.80 ± 0.15, while the serum protein binding (SPB) was <17%. The percentages of binding to LNCaP cells were 4.07 ± 0.51% (30 min) and 4.56 ± 0.46% (60 min), while 19.22 ± 2.73% (30 min) and 16.85 ± 1.34% (60 min) of bound material was internalized. High accumulation of [68Ga]Ga-PSMA-11 was observed in the kidneys, spleen, and tumor, with a tumor-to-contralateral-muscle ratio of >8.5 and a tumor-to-blood ratio of >3.5. In conclusion, an automatic synthesis module-based radiolabeling protocol for [68Ga]Ga-PSMA-11 was standardized and the product was evaluated, thus verifying its characteristics for PET imaging of PCa tumors in a clinical environment.

S178 – Utility of CT-Sestamibi Fusion in Parathyroid Exploration

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P135-P136
Author(s):  
Michael J Clark ◽  
Phillip Pellitteri
Keyword(s):  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Image Fusion ◽  
Fusion Imaging ◽  
Parathyroid Glands ◽  
Preoperative Localization ◽  
Minimally Invasive Surgical ◽  
Sestamibi Imaging ◽  
Invasive Surgical Approach ◽  
Operative Findings

Objectives 1) Delineate the role of CT-technetium 99m sestamibi (CT-MIBI) fusion in directed parathyroidectomy. 2) Determine the clinical situations where CT-MIBI fusion would be strongly recommended. Methods Charts from 190 patients with primary hyperparathyroidism who underwent CT-MIBI mage fusion as a part of a scan directed, minimally invasive parathyroid exploration protocol were reviewed. The results of conventional sestamibi imaging and CT-MIBI image fusion were compared with operative findings. Results CT-MIBI image fusion accurately localized solitary hyperfunctional parathyroid glands in 70% of patients imaged; 55% of patients were localized with conventional sestamibi imaging. CT-MIBI fusion imaging was most accurate and predictive when conventional images suggested that the solitary gland was separated from the thyroid or when the adenoma was located in the retro-thyroidal/ retro-esophageal plane or mediastinum. Conclusions CT-MIBI image fusion is not superior to conventional sestamibi imaging when utilized for routine localization of hyperfunctional parathyroid glands. CT-MIBI fusion is of greatest benefit in guiding the directed approach to solitary glands, which are separate from the thyroid or ectopically located, regions where conventional imaging has proven to be less accurate. This imaging technique will augment the minimally invasive surgical approach in selected patients with primary hyperparathyroidism in order to further refine the focused technique. Its utility as the standard preoperative localization modality is not yet established and requires further investigation. Evaluation of differences in facility utilization with CT-MIBI image fusion and conventional sestamibi imaging may be helpful in determining its role in preoperative localization for hyperparathyroidism.

scholarly journals Imaging predictive factors and exercise training in CRT patients

2016 ◽  
Vol 86 (1-2) ◽  
Author(s):  
Ana Abreu ◽  
Helena Santa Clara
Keyword(s):  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Conduction Delay ◽  
Lv Function ◽  
Scar Burden ◽  
Intraventricular Conduction

<p>Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120msec or more on a 12-lead electrocardiogram (ECG). CRT improved functional capacity, reduced hospitalizations for worsening CHF and increased survival. However, about 30-40% of patients who underwent CRT were non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed. Cardiac magnetic resonance (CMR), recognized as the gold standard to assess viability, has shown to obtain good results regarding quantification of scar burden. CMR-derived measures of mechanical dyssynchrony appear to predict the outcome of CRT, however they have not been externally validated. Nuclear imaging techniques, namely single-photon emission cardiac tomography (SPECT) provide data on scar burden and location, left ventricular (LV) function, LV contraction and mechanical dyssynchrony from a single scan. The presence, location and burden of myocardial scar have been shown to affect response to CRT. However, compared to CMR, the low spatial resolution of scintigraphy might overestimate the scar extent. This problem can be overcome by positron emission tomography (PET). SPECT has also been used to quantify dyssynchrony, using phase analysis. Imaging investigation is ongoing, trying to better identifying CRT non-responders. The combination of ExT in CRT has not been well investigated; however some data show different aerobic exercise modes and intensities can further improve CRT benefits. Data available on the effects of ExT in patients with CRT have been reviewed.</p>

scholarly journals Radionuclide-Based Imaging of Breast Cancer: State of the Art

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5459
Author(s):  
Huiling Li ◽  
Zhen Liu ◽  
Lujie Yuan ◽  
Kevin Fan ◽  
Yongxue Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Molecular Imaging ◽  
Single Photon ◽  
Morphological Changes ◽  
Imaging Techniques ◽  
Rapid Development ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Biological Processes ◽  
Functional Perspective

Breast cancer is a malignant tumor that can affect women worldwide and endanger their health and wellbeing. Early detection of breast cancer can significantly improve the prognosis and survival rate of patients, but with traditional anatomical imagine methods, it is difficult to detect lesions before morphological changes occur. Radionuclide-based molecular imaging based on positron emission tomography (PET) and single-photon emission computed tomography (SPECT) displays its advantages for detecting breast cancer from a functional perspective. Radionuclide labeling of small metabolic compounds can be used for imaging biological processes, while radionuclide labeling of ligands/antibodies can be used for imaging receptors. Noninvasive visualization of biological processes helps elucidate the metabolic state of breast cancer, while receptor-targeted radionuclide molecular imaging is sensitive and specific for visualization of the overexpressed molecular markers in breast cancer, contributing to early diagnosis and better management of cancer patients. The rapid development of radionuclide probes aids the diagnosis of breast cancer in various aspects. These probes target metabolism, amino acid transporters, cell proliferation, hypoxia, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), gastrin-releasing peptide receptor (GRPR) and so on. This article provides an overview of the development of radionuclide molecular imaging techniques present in preclinical or clinical studies, which are used as tools for early breast cancer diagnosis.

Nuclear cardiology: state of the art

Heart ◽  
2021 ◽  
pp. heartjnl-2019-315628
Author(s):  
Rebecca Schofield ◽  
Leon Menezes ◽  
Stephen Richard Underwood
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Radionuclide Imaging ◽  
Single Photon ◽  
Imaging Techniques ◽  
Sympathetic Innervation ◽  
Photon Emission ◽  
Myocardial Inflammation ◽  
Emission Computed Tomography ◽  
Device Infection

Radionuclide imaging remains an essential component of modern cardiology. There is overlap with the information from other imaging techniques, but no technique is static and new developments have expanded its role. This review focuses on ischaemic heart disease, heart failure, infection and inflammation. Radiopharmaceutical development includes the wider availability of positron emission tomography (PET) tracers such as rubidium-82, which allows myocardial perfusion to be quantified in absolute terms. Compared with alternative techniques, myocardial perfusion scintigraphy PET and single photon emission computed tomography (SPECT) have the advantages of being widely applicable using exercise or pharmacological stress, full coverage of the myocardium and a measure of ischaemic burden, which helps to triage patients between medical therapy and revascularisation. Disadvantages include the availability of expertise in some cardiac centres and the lack of simple SPECT quantification, meaning that global abnormalities can be underestimated. In patients with heart failure, despite the findings of the STICH (Surgical Treatment for Ischemic Heart Failure) trial, there are still data to support the assessment of myocardial hibernation in predicting when abolition of ischaemia might lead to improvement in ventricular function. Imaging of sympathetic innervation is well validated, but simpler markers of prognosis mean that it has not been widely adopted. There are insufficient data to support its use in predicting the need for implanted devices, but non-randomised studies are promising. Other areas where radionuclide imaging is uniquely valuable are detection and monitoring of endocarditis, device infection, myocardial inflammation in sarcoidosis, myocarditis and so on, and reliable detection of deposition in suspected transthyretin-related amyloidosis.

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