scholarly journals A Rare Case of Solitary Parathyroid Adenoma presenting with Recurrent Pancreatitis detected by Dual-phase Single-isotope Imaging (Technetium Sestamibi and Technetium Thyroid Scan) with SPECT-CT

2016 ◽  
Vol 8 (2) ◽  
pp. 175-178
Author(s):  
Amit Sharma ◽  
Arun R John ◽  
Anurag Jain ◽  
Madan G Vishnoi ◽  
Dharmesh Paliwal ◽  
...  

ABSTRACT Primary hyperparathyroidism is a rare cause of acute pancreatitis with a rather uncommon association according to existing literature. We present a rare case of recurrent pancreatitis with primary hyperparathyroidism resulting from a solitary parathyroid adenoma detected by a dual-phase singleisotope imaging protocol using technetium pertechnetate and technetium sestamibi followed by a single-photon emission computed tomography (SPECT)-CT. The case demonstrates the requirement of a high index of suspicion of primary hyperparathyroidism as one of the etiologies in patients presenting with recurrent pancreatitis. This case highlights the role of dualphase single-isotope imaging (technetium pertechnetate and technetium sestamibi scan) along with SPECT-CT for precise anatomical localization of a parathyroid adenoma, which is of paramount importance to the surgeon for meticulous planning and execution of the surgical procedure. How to cite this article John AR, Jain A, Vishnoi MG, Paliwal D, Sharma A, Kumar N, Dubey IP. A Rare Case of Solitary Parathyroid Adenoma presenting with Recurrent Pancreatitis detected by Dual-phase Single-isotope Imaging (Technetium Sestamibi and Technetium Thyroid Scan) with SPECT-CT. World J Endoc Surg 2016;8(2):175-178.

2016 ◽  
Vol 67 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Wade Koberstein ◽  
Christopher Fung ◽  
Kristy Romaniuk ◽  
Jonathan T. Abele

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.


2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Michele L. Taubman ◽  
Melanie Goldfarb ◽  
John I. Lew

Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient population. This condition is usually the result of a single hyperfunctioning parathyroid gland. Targeted parathyroidectomy guided by intraoperative parathyroid hormone monitoring (IPM) through a small cervical incision has replaced traditional bilateral neck exploration (BNE) as the initial approach in the surgical treatment of primary hyperparathyroidism at many medical centers worldwide. Preoperative sestamibi-technetium 99m scintigraphy serves as an important prerequisite for successful targeted parathyroidectomy. Single-photon emission computed tomography (SPECT) and CT fusion, however, is a recent imaging technique that provides a three-dimensional functional image with advanced contrast resolution to greatly improve preoperative localization of parathyroid tumors.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicola Beindorff ◽  
Fabian Schmitz-Peiffer ◽  
Daniel Messroghli ◽  
Winfried Brenner ◽  
Janet F. Eary

AbstractOther than in animal models of human disease, little functional imaging has been performed in most of the animal world. The aim of this study was to explore the functional anatomy of the European round back slug (Arionidae) and leopard slug (Limacidae) and to establish an imaging protocol for comparative species study. Radionuclide images with single photon emission computed tomography (SPECT) and positron emission tomography (PET) were obtained after injections of standard clinical radiopharmaceuticals 99mtechnetium dicarboxypropane diphosphonate (bone scintigraphy), 99mtechnetium mercaptoacetyltriglycine (kidney function), 99mtechnetium diethylenetriaminepentaacetic acid (kidney function), 99mtechnetium pertechnetate (mediated by the sodium-iodide symporter), 99mtechnetium sestamibi (cardiac scintigraphy) or 18F-fluoro-deoxyglucose (glucose metabolism) in combination with magnetic resonance imaging (MRI) and computed tomography (CT) for uptake anatomic definition. Images were compared with anatomic drawings for the Arionidae species. Additionally, organ uptake data was determined for a description of slug functional anatomy in comparison to human tracer biodistribution patterns identifying the heart, the open circulatory anatomy, calcified shell remnant, renal structure (nephridium), liver (digestive gland) and intestine. The results show the detailed functional anatomy of Arionidae and Limacidae, and describe an in vivo whole-body imaging procedure for invertebrate species.


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