99mTc-MIBI-SPECT: Eine nicht invasive, sensitive Lokalisationsdiagnostik bei Verdacht auf Nebenschilddrüsenadenom

2018 ◽  
Vol 41 (02) ◽  
pp. 121-127
Author(s):  
Christina Schneider ◽  
Constanza Chiapponi ◽  
Monika Ortmann ◽  
Michael Faust ◽  
Markus Dietlein ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pet Ct ◽  
Ablative Verfahren ◽  
99Mtc Mibi ◽  
Met Pet ◽  
Mibi Spect

ZusammenfassungDie Aufgabe des Nuklearmediziners nach Diagnosestellung eines meist primären Hyperparathyreoidismus besteht in der erfolgreichen Lokalisation eines oder mehrerer Nebenschilddrüsenadenome. Die präoperative Lokalisation erlaubt die gezielte, heutzutage oft minimalinvasive Resektion. Hierzu ist 99 mTc-MIBI-SPECT eine klinisch fest etablierte Methode mit hoher Sensitivität. Wichtig ist die Kenntnis über Einflussfaktoren, die zu falsch-positiven oder falsch-negativen Ergebnissen führen. Eine wichtige Differenzialdiagnose für eine pathologische Anreicherung ist ein MIBI-positiver Schilddrüsenknoten. Häufigere Ursachen für negative Befunde sind kleinere hyperplastische Nebenschilddrüsen oder ein Vitamin-D-Mangel. In manchen Zentren ist als weiterführende Lokalisationsmethode C-11-MET PET/CT verfügbar. Ob sich neben der chirurgischen Therapie in Zukunft perkutan-ablative Verfahren etablieren können, was eine gezielte prätherapeutische Lokalisation voraussetzt, kann zum jetzigen Zeitpunkt noch nicht definitiv beantwortet werden.

99mTc-MIBI SPECT in primary hyperparathyroidism

2008 ◽  
Vol 47 (01) ◽  
pp. 01-07 ◽  
Author(s):  
N. Thoma ◽  
M. Dietlein ◽  
D. Moka ◽  
W. Eschner ◽  
M. Faust ◽  
...  
Keyword(s):  
Vitamin D ◽  
Primary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Statistical Significance ◽  
Negative Influence ◽  
Normal Vitamin ◽  
Planar Images ◽  
99Mtc Mibi ◽  
Mibi Spect ◽  
Spect Images

SummaryAim of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of 99mTc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT). Patients, methods: Between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a 99mTc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase 99mTc-MIBI protocol with SPECT were compared with histopathology. Results: In 54 pts with normal vitamin D values late SPECT images identified more lesions (n = 51, sensitivity 91%) than early planar (n = 45, sensitivity 82%) or late planar images (n = 50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n = 13, sensitivity 72%) than early planar (n = 10, sensitivity 56%) or late planar images (n = 10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a 99mTc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p = 0.1625; late planar: p = 0.0039; 99mTc-MIBI SPECT: p = 0.1180. Conclusion: The likelihood of a pathological 99mTc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency.

Abstract #185 Efficacy of 18F-Fluorocholine PET/ CT, 99MTC-MIBI Spect/CT and Highresolution Neck US in the Detection of Parathyroid Adenomas

2019 ◽  
Vol 25 ◽  
pp. 52-53
Author(s):  
Franco Grimaldi ◽  
Elda Kara ◽  
Silvia Maria Sciannimanico ◽  
Claudia Cipri ◽  
Silvia Galasso ◽  
...  
Keyword(s):  
Pet Ct ◽  
Parathyroid Adenomas ◽  
99Mtc Mibi ◽  
Mibi Spect

11C-methionine PET/CT after in conclusive 99mTc-MIBI-SPECT/CT for localisation of parathyroid adenomas in primary hyperparathyroidism

2015 ◽  
Vol 54 (01) ◽  
pp. 26-30 ◽  
Author(s):  
U. Braeuning ◽  
C. Pfannenberg ◽  
B. Gallwitz ◽  
R. Teichmann ◽  
M. Mueller ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Familial Hypocalciuric Hypercalcemia ◽  
Imaging Data ◽  
True Negative ◽  
Pet Ct ◽  
Parathyroid Adenomas ◽  
99Mtc Mibi ◽  
Excised Tissue ◽  
Mibi Spect

Summary Aim: To investigate the efficacy of PET/CT with 11C-methionine for localizing parathyroid adenomas in patients with suspected primary hyperparathyroidism and inconclusive results of cervical ultrasonography and 99mTc-MIBI-SPECT/CT. Patients, method: Retrospective analysis of imaging data of 18 patients and correlation with clinical outcome, in particular intraoperative findings and histopathology of excised tissue. Results: 12 of 18 patients received surgery. In 10 patients single parathyroid adenomas were found (diameter: 5–20 mm), 2 patients presented parathyroid hyperplasia (5 excised hyperplastic glands (diameter: 2–12 mm). PET/ CT correctly localized all adenomas and 1 of 5 hyperplastic glands. The sensitivity per patient was 91.7% (11 of 12), the sensitivity per lesion 73.3% (11 of 15). All lesions missed by PET/CT had a size smaller than 9 mm and a volume of less than 0.2 ml. In 6 patients no surgery was performed. Five of them had a negative or atypical PET/CT. Further follow-up indicated familial hypocalciuric hypercalcemia in 3 of them (thus, PET/CT true negative), in the remaining 2 patients no validation is available. One patient with 2 highly suggestive lesions rejected surgery so far. Conclusion: PET/CT with 11C-methionine is a very sensitive method for the detection of parathyroid adenomas, even if they are too small to be visualized by 99mTc-MIBI-SPECT/CT.

Comparison of diagnostic accuracy of 18F-FDG PET, 123I-IMT- and 99mTc-MIBI SPECT

2006 ◽  
Vol 45 (01) ◽  
pp. 49-56 ◽  
Author(s):  
N. Özdemir-Sahin ◽  
P. Hipp ◽  
W. Mier ◽  
M. Eisenhut ◽  
J. Debus ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fdg Pet ◽  
Tumour Progression ◽  
Roc Curves ◽  
Low Grade ◽  
Who Grade ◽  
Pet Tracer ◽  
Patient Groups ◽  
99Mtc Mibi ◽  
Mibi Spect

Summary Aim was to evaluates the diagnostic accuracy of the SPECTtracers 3-123I-α-methyl-L-tyrosine (IMT) and 99mTc(I)- hexakis(2-methoxyisobutylisonitrile) (MIBI) as well as the PET-tracer 2-18F-2-deoxyglucose (FDG) for detecting tumour progression in irradiated low grade astrocytomas (LGA). Patients, methods: We examined 91 patients (56 males; 35 females; 44.7 ± 11.5 years), initially suffering from histologically proven LGAs (mean WHO grade II) and treated by stereotactic radiotherapy (59.0 ± 4.6 Gy). On average 21.9 ± 11.2 months after radiotherapy, patients presented new Gd-DTPA enhancing lesions on MRI, which did not allow a differentiation between progressive tumour (PT) and non-PT (nPT) at this point of time. PET scans (n=82) were acquired 45 min after injection of 208 ± 32 MBq FDG. SPECT scans started 10 min after injection of 269 ± 73 MBq IMT (n=68) and 15 min after injection of 706 ± 63 MBq MIBI (n=34). Lesions were classified as PT and nPT based on prospective follow-up (clinically, MRI) for 17.2 ± 9.9 months after PET/SPECT. Lesion-to-normal ratios (L/N) were calculated using contra lateraly mirrored reference regions for the SPECT examinations and reference regions in the contra lateral grey (GM) and white matter (WM) for FDG PET. Ratios were evaluated by Receiver Operating Characteristic (ROC) analysis. Results: In the patient groups nPT and PT, L/N ratios for FDG (GS) were 0.6 ± 0.3 vs. 1.2 ± 0.5 (p = 0.003), for FDG (WS) 1.2 ± 0.4 vs. 2.6 ± 0.4 (p <0.001), for IMT 1.1 ± 0.1 vs. 1.8 ± 0.4 (p <0.001) and for MIBI 1.6 ± 0.7 vs. 2.6 ± 2.2 (p = 0.554). Areas under the non-parametric ROC-curves were: 0.738 ± 0.059 for FDG (GS), 0.790 ± 0.057 for FDG (WS), 0.937 ± 0.037 for IMT and 0.564 ± 0.105 for MIBI. Conclusion: MIBI-SPECT examinations resulted in a low accuracy and especially in a poor sensitivity even at modest specificity values. A satisfying diagnostic accuracy was reached with FDG PET. Using WM as reference region for FDG PET, a slightly higher AUC as compared to GM was calculated. IMT yielded the best ROC characteristics and the highest diagnostic accuracy for differentiating between PT and nPT in irradiated LGA.

Einschränkung der myokardialen Perfusionsreserve bei Mikrovaskular-Angina (Syndrom X): Nachweis durch 99mTc-MIBI-SPECT

1996 ◽  
Vol 35 (06) ◽  
pp. 193-197 ◽  
Author(s):  
B. Beuthien-Baumann ◽  
M. Lübeck ◽  
C. Fuchs ◽  
M. A. Schneider ◽  
C. Volk ◽  
...  
Keyword(s):  
Angina Pectoris ◽  
99Mtc Mibi ◽  
Mibi Spect

Zusammenfassung Ziel: An 22 Patienten mit typischer Angina pectoris und normalen Koronararterien (Mikrovaskular-Angina, Syndrom X) wurde geprüft, ob mit 99mTc-MIBI-SPECT eine Einschränkung der myokardialen Perfusionsreserve nachweisbar ist. Methode: Die Untersuchung mit 99rnTc-MIBI-SPECT erfolgte in Ruhe und unter Vasodilatation nach einer Infusion mit Dipyridamol im Vergleich zu einer normalen Datenbank. Eine normale myokardiale Perfusionsreserve wurde bei einer differenziellen 99mTc-MIBI-Aufnahme von > 20% angesehen. Ergebnisse: 2/22 (9%) der Patienten wiesen eine Perfusionsreserve <20% mit im Mittel 37% auf, 91 % der Patienten wiesen eine relativ oder absolut verminderte 99mTc-MIBI-Aufnahme unter Vasodilatation auf. Bei 9/22 (41 %) Patienten war die Perfusionsreserve relativ gemindert mit einer Zunahme der 99mTc-MIBI-Aktivität von 6%, bei 11/22 wurde eine Abnahme der 99mTc-MIBI-Aktivität um 13% unter Vasodilatation dokumentiert. Schlußfolgerung: Bei guter Bildqualität ist die 99mTc-MIBI-SPECT zur semiquantitativen Bestimmung der Perfusionsreserve bei Patienten mit Mikrovaskular-Angina geeignet.

scholarly journals Molecular Imaging with 18F-FDG PET/CT and 99mTc-MIBI SPECT/CT in Osteitis Fibrosa Cystica Generalisata

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1355
Author(s):  
Adrien Holzgreve ◽  
Matthias P. Fabritius ◽  
Thomas Knösel ◽  
Lena M. Mittlmeier ◽  
Johannes Rübenthaler ◽  
...  
Keyword(s):  
Molecular Imaging ◽  
Fdg Pet ◽  
Correct Diagnosis ◽  
Osteitis Fibrosa ◽  
Osteitis Fibrosa Cystica ◽  
Pet Ct ◽  
Brown Tumors ◽  
18F Fdg ◽  
99Mtc Mibi ◽  
Fdg Pet Ct

Benign so-called “brown tumors” secondary to hyperparathyroidism are a rare diagnostic pitfall due to their impressively malignant-like character in various imaging modalities. We present the case of a 65-year-old male patient with multiple unclear osteolytic lesions on prior imaging suspicious for metastatic malignant disease. Eventually, findings of 18F-FDG PET/CT staging and 99mTc-MIBI scintigraphy resulted in revision of the initially suspected malignant diagnosis. This case illustrates how molecular imaging findings non-invasively corroborate the correct diagnosis of osteitis fibrosa cystica generalisata with the formation of multiple benign brown tumors.

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