Sensitivity and Specificity of Dual-Isotope 99mTc-Tetrofosmin and 123I Sodium Iodide Single Photon Emission Computed Tomography (SPECT) in Hyperparathyroidism.

Details

Serval ID
serval:BIB_AE4F9351101B
Type
Article: article from journal or magazin.
Collection
Publications
Title
Sensitivity and Specificity of Dual-Isotope 99mTc-Tetrofosmin and 123I Sodium Iodide Single Photon Emission Computed Tomography (SPECT) in Hyperparathyroidism.
Journal
PloS one
Author(s)
Sommerauer M., Graf C., Schäfer N., Huber G., Schneider P., Wüthrich R., Schmid C., Steinert H.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
10
Number
6
Pages
e0129194
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Despite recommendations for 99mTc-tetrofosmin dual tracer imaging for hyperparathyroidism in current guidelines, no report was published on dual-isotope 99mTc-tetrofosmin and 123I sodium iodide single-photon-emission-computed-tomography (SPECT). We evaluated diagnostic accuracy and the impact of preoperative SPECT on the surgical procedures and disease outcomes.
Analysis of 70 consecutive patients with primary hyperparathyroidism and 20 consecutive patients with tertiary hyperparathyroidism. Imaging findings were correlated with surgical results. Concomitant thyroid disease, pre- and postoperative laboratory measurements, histopathological results, type and duration of surgery were assessed.
In primary hyperparathyroidism, SPECT had a sensitivity of 80% and a positive predictive value of 93% in patient-based analysis. Specificity was 99% in lesion-based analysis. Patients with positive SPECT elicit higher levels of parathyroid hormone and higher weight of resected parathyroids than SPECT-negative patients. Duration of parathyroid surgery was on average, approximately 40 minutes shorter in SPECT-positive than in SPECT-negative patients (89 ± 46 vs. 129 ± 41 minutes, p = 0.006); 86% of SPECT-positive and 50% of SPECT-negative patients had minimal invasive surgery (p = 0.021). SPECT had lower sensitivity (60%) in patients with tertiary hyperparathyroidism; however, 90% of these patients had multiple lesions and all of these patients had bilateral lesions.
Dual-isotope SPECT with 99mTc-tetrofosmin and 123I sodium iodide has a high diagnostic value in patients with primary hyperparathyroidism and allows for saving of operation time. Higher levels of parathyroid hormone and higher glandular weight facilitated detection of parathyroid lesion. Diagnostic accuracy of preoperative imaging was lower in patients with tertiary hyperparathyroidism.

Keywords
Adult, Aged, Female, Humans, Hyperparathyroidism/diagnosis, Hyperparathyroidism/diagnostic imaging, Hyperparathyroidism/surgery, Hyperparathyroidism, Primary/diagnosis, Hyperparathyroidism, Primary/diagnostic imaging, Hyperparathyroidism, Primary/surgery, Iodine Radioisotopes, Male, Middle Aged, Organophosphorus Compounds, Organotechnetium Compounds, Outcome Assessment (Health Care)/methods, Outcome Assessment (Health Care)/statistics & numerical data, Parathyroid Glands/diagnostic imaging, Parathyroid Glands/pathology, Parathyroid Glands/surgery, Preoperative Period, Reproducibility of Results, Sensitivity and Specificity, Sodium Iodide, Tomography, Emission-Computed, Single-Photon/methods
Pubmed
Web of science
Open Access
Yes
Create date
09/10/2017 16:12
Last modification date
20/08/2019 15:18
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