Differential Diagnostic Value of Parathyroid 99mTc-MIBI SPECT/CT in MIBI Uptake Lesion

2020 ◽  
Author(s):  
Ri Sa ◽  
Danyan Liu ◽  
Sen Hou ◽  
Hongguang Zhao ◽  
Feng Guan
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Single Photon ◽  
Photon Emission ◽  
Nodular Goiter ◽  
Multivariable Logistic Regression Analysis ◽  
Emission Computed Tomography ◽  
Pathological Findings ◽  
Serum Pth ◽  
Mibi Spect

Abstract Background: To investigate the role of parathyroid technetium-99m-hexakis2-methoxy-2-methylpropylisonitrile (99mTc-MIBI) single photon emission computed tomography/ computed tomography (SPECT/CT) combined with the serum calcium (Ca) and serum parathyroid hormone (PTH) in the differential diagnosis of MIBI uptake lesion. Methods: 201 patients with MIBI uptake lesion on parathyroid 99mTc-MIBI SPECT/CT from January 2015 to July 2019 were enrolled in this study. All patients who underwent surgical resection were classified into two groups: primary hyperparathyroidism (PHPT) and non-PHPT in terms of the pathological findings. Radiological performance of 99mTc-MIBI SPECT/CT, serum Ca and serum PTH were comparable between the two groups.Results: 201 patients (135 females; median age, 53.0 years; age range, 29 – 79 years) were included. Pathological findings were as follows: PHPT was in 126 (62.7%) patients, including parathyroid adenoma in 106 patients, parathyroid cancer in 12 patients and parathyroid hyperplasia in 8 patients, while non-PHPT were in 75 (37.3%) patients, including thyroid adenoma in 14 patients, thyroid papillary cancer in 15 patients and thyroid nodular goiter in 46 patients. In the following multivariable logistic regression analysis, serum Ca and diameter of the shortest axis of the lesion were the independent factors for differentiating PHPT from non-PHPT. In receiver operating characteristic (ROC) analyses, the cut-off value of serum Ca differentiating PHPT from non-PHPT was 2.6 mmol/L, yielding the area under the ROC curve (AUC) of 0.931, sensitivity of 85.7%, specificity of 89.2%; the cut-off value of diameter of the shortest axis of the lesion was 20.4mm, yielding AUC of 0.728, sensitivity of 62.2%, specificity of 87.1%.Conclusion: Parathyroid 99mTc-MIBI SPECT/CT combined with serum Ca and serum PTH contributed to the differential diagnosis of PHPT from non-PHPT, evenly can assist the determination of the specific pathology of MIBI uptake lesion before surgery.

scholarly journals Detecting Synchronous Parathyroid Adenoma and False-Positive Findings on Technetium-99m MIBI Single Photon-Emission Computed Tomography/Computed Tomography

Diagnostics ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. 57
Author(s):  
Ji Lee ◽  
Hee-Sung Song ◽  
Jae Choi ◽  
Chang Hyun ◽  
Sang Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Thyroid Disease ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Planar Images ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography ◽  
Mibi Spect

Technetium (Tc)-99m-methoxyisobutylisonitrile (MIBI) single photon-emission computed tomography/computed tomography (SPECT/CT) is now being used increasingly for preoperative localization of parathyroid adenomas. Tc-99m-MIBI scintigraphy in a 52-year-old man with a diagnosis of primary hyperparathyroidism revealed two focal areas with retention of radioactivity in the left lobe of the thyroid gland on the delayed phase of MIBI SPECT/CT but no significant focal radioactive uptake on MIBI planar images. The patient subsequently underwent left partial parathyroidectomy. Histological analysis identified one lesion to be thyroid hyperplasia and the other to be parathyroid adenoma. This case demonstrates the value of MIBI SPECT/CT for localization of a parathyroid lesion when compared with planar images and that false-positive findings can lead to misdiagnosis in a patient with coexisting thyroid disease. An appropriate diagnostic work-up that includes Tc-99m MIBI SPECT/CT in addition to ultrasonography is helpful for an accurate diagnosis in patients with concomitant thyroid disease.

Accuracy of Dual Phase Single-Photon Emission Computed Tomography/Computed Tomography in Primary Hyperparathyroidism: Correlation with Serum Parathyroid Hormone Levels

2016 ◽  
Vol 67 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Wade Koberstein ◽  
Christopher Fung ◽  
Kristy Romaniuk ◽  
Jonathan T. Abele
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Predictive Value ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Dual Phase ◽  
Parathyroid Adenomas ◽  
Ectopic Parathyroid ◽  
Serum Pth

Purpose The objectives of this study were: 1) to determine the accuracy of dual-phase 99mTc -methoxyisobutylisonitrile (MIBI) with single-photon emission computed tomography/computed tomography (SPECT/CT) for the preoperative localization of parathyroid adenomas in the setting of primary hyperparathyroidism; 2) to determine the accuracy of localization for ectopic glands; and 3) to assess the relationship between accuracy and serum parathyroid hormone (PTH) levels. Methods Eighty-eight patients who underwent 99mTc-MIBI SPECT/CT imaging for primary hyperparathyroidism at our institution over a 27-month period were retrospectively assessed. The preoperative SPECT/CT results were compared to intraoperative findings (within 1 year of imaging). The relationship between serum PTH level (within 3 months) and SPECT/CT accuracy was then evaluated. Results Accuracy indices for the retrothyroid subgroup were sensitivity 86.7%, specificity 96.4%, positive predictive value 98.1%, negative predictive value 77.1%, and accuracy 89.8%. Accuracy indices for ectopic parathyroid adenomas were sensitivity 81.5%, specificity 100%, positive predictive value 100%, negative predictive value 92.4%, and accuracy 94.3%. For the overall group, SPECT/CT demonstrated a sensitivity of 85.1% and a PPV of 98.7%. SPECT/CT correctly identified the abnormal parathyroid gland in 60% of patients with a normal serum PTH (<6.9 pmol/L), 73% between 6.9-9.9 pmol/L, 86% between 10.0-14.9 pmol/L, 100% between 15.0-19.9 pmol/L, 88% between 20.0-24.5 pmol/L, and 100% of patients with a PTH greater than 25.0 pmol/L. Conclusions Dual-phase 99mTc- MIBI with SPECT/CT is an accurate and reliable means to correctly localize both retrothyroid and ectopic parathyroid adenomas for the purpose of surgical planning. The accuracy of SPECT/CT increases with increasing serum PTH levels.

scholarly journals The Role of Frontal Assessment Battery and Frontal Lobe Single-Photon Emission Computed Tomography in the Differential Diagnosis of Progressive Supranuclear Palsy Variants and Corticobasal Syndrome—A Pilot Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Piotr Alster ◽  
Bartosz Migda ◽  
Natalia Madetko ◽  
Karolina Duszyńska-Wąs ◽  
Agnieszka Drzewińska ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Progressive Supranuclear Palsy ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Frontal Assessment Battery ◽  
Single Photon Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS) are clinical syndromes classified as atypical parkinsonism. Due to their overlapping symptomatology, recent research shows the necessity of finding new methods of examination of these clinical entities. PSP is a heterogenic disease. PSP Richardson-Steele Syndrome (PSP-RS) and parkinsonism predominant (PSP-P) are the most common clinical variants of progressive supranuclear palsy syndrome. The different clinical course and life expectancy of PSP-RS and PSP-P stress the need of efficient examination in the early stages. The aim of the study was to evaluate the possible feasibility of the combined use of frontal assessment battery (FAB) and single-photon emission computed tomography (SPECT) in the differentiation of PSP-RS, PSP-P, and CBS. The findings show that FAB may be interpreted as a possible supplementary tool in the differential diagnosis of PSP-P and PSP-RS. The differences in SPECT are less pronounced. The study does not show any advantages of performing combined frontal SPECT and FAB in the differential examination of PSP and CBS. Moreover, PSP-RS and CBS, in a detailed evaluation of the frontal lobe, do not show any significant differences. This is a relatively small study which, however, highlights the relevant features of clinical examination of these rare entities.

The Value of 99mTc-MIBI SPECT/CT in the Postoperative Assessment of Patients with Differentiated Thyroid Carcinoma

2021 ◽  
Vol 17 ◽  
Author(s):  
Berna Okudan ◽  
Bedri Seven ◽  
Nedim C.M. Gülaldı ◽  
Mustafa Çapraz ◽  
Yusuf Açıkgöz
Keyword(s):  
Computed Tomography ◽  
Thyroid Carcinoma ◽  
Single Photon ◽  
Lung Metastases ◽  
Photon Emission ◽  
Differentiated Thyroid Carcinoma ◽  
Whole Body ◽  
Emission Computed Tomography ◽  
99Mtc Mibi ◽  
Mibi Spect

Background: The therapeutic approaches of differentiated thyroid carcinoma (DTC) are surgery, ablation therapy with the postoperative use of radioiodine-131 (131I), and thyroid-stimulating hormone (TSH) suppression therapy. After the surgical therapy, the patient should be assessed for remnants/metastases. Objective: The purpose of this research was to investigate the role of technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT) in the postoperative management of patients with DTC. Methods: The study comprised 22 DTC patients (13 women, 9 men; mean age 46.55 ± 13.27 y) who underwent a total thyroidectomy previously. All patients were investigated for thyroid remnants/metastases by 99mTc-MIBI SPECT/CT, posttherapy 131I whole-body scan (WBS) and ultrasound (US). Serum TSH, thyroglobulin and anti-Tg antibody levels were measured. Results of imaging modalities and laboratory measurements were compared with each other. Results: 99mTc-MIBI SPECT/CT, 131I WBS and US respectively demonstrated thyroid remnants in 15 (68.18%), 22 (100%) and 14 (63.63%) of the all patients and metastatic lymph nodes in 8 (100%), 6 (75%) and 6 (75%) of the 8 patients with lymph node metastases. 99mTc-MIBI SPECT/CT also demonstrated lung metastases in 2 patients (9.09% of all patients). The same result was obtained with 131I WBS. Conclusion : The findings of this study show that 99mTc-MIBI SPECT/CT can be effective for detecting metastases in patients with DTC who underwent surgery prior to 131I therapy.

Usefulness of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography and computed tomography in the evaluation of cervical lymph node metastasis

2005 ◽  
Vol 119 (11) ◽  
pp. 882-887 ◽  
Author(s):  
Byung-Joo Lee ◽  
Soo-Geun Wang ◽  
Eui-Kyung Goh ◽  
Jun-Young Kim ◽  
In-Ju Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Lymph Node ◽  
Single Photon ◽  
Photon Emission ◽  
Cervical Lymph Node Metastasis ◽  
Emission Computed Tomography ◽  
Node Metastasis ◽  
Mibi Spect

The aim of this study was to compare the effectiveness of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) single-photon emission computed tomography (SPECT) and computed tomography (CT) in evaluating cervical lymph node metastasis of head and neck cancer. Histopathologic results of 166 cervical lymph node levels in 31 neck-dissected patients were compared with pre-operative CT and 99mTc-MIBI SPECT findings about cervical lymph node metastasis, retrospectively. Sensitivity, specificity and predictability of CT and 99mTc-MIBI SPECT were 68.2, 93.1 and 89.8 per cent and 59.1, 87.5 and 83.7 per cent, respectively. When analysing CT and99mTc-MIBI SPECT together, sensitivity and specificity were 86.4 and 99.3 per cent, respectively. The combined use of 99mTc-MIBI SPECT and CT could increase the accuracy of cervical lymph node metastases detection, compared with separate use of either 99mTc-MIBI SPECT or CT.

Sign in / Sign up

Export Citation Format

Share Document