| Autor: |
Carlier, Thomas, Oudoux, Aurore, Mirallié, Eric, Seret, Alain, Daumy, Isabelle, Leux, Christophe, Bodet-Milin, Caroline, Kraeber-Bodéré, Françoise, Ansquer, Catherine |
| Předmět: |
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| Zdroj: |
European Journal of Nuclear Medicine & Molecular Imaging; Mar2008, Vol. 35 Issue 3, p637-643, 7p, 1 Color Photograph, 4 Charts |
| Abstrakt: |
A pinhole collimator is routinely used to increase the resolution of scintigraphy. This prospective study was conducted to determine the interest of 99mTc-MIBI pinhole single-photon emission computed tomography (SPECT) for the preoperative localisation of parathyroid lesions in primary hyperparathyroidism. All patients underwent a neck ultrasonography (US), $$ ^{{99{\text{m}}}} {\text{TcO}}^{{\text{ - }}}_{{\text{4}}} $$ and 99mTc-MIBI planar images and two consecutive SPECT with a parallel (C-SPECT) and a pinhole collimator (P-SPECT). P-SPECT was performed with a tilted detector equipped with a pinhole collimator and reconstructed with a dedicated OSEM algorithm. A diagnostic confidence score (CS) was assigned to each procedure considering intensity and extra-thyroidal location of suspected lesions: 0 = negative, 1 = doubtful, 2 = moderately positive, 3 = positive. The results of these preoperative localisation studies were compared with surgical, pathological and 6-month biological findings. Fifty-one patients cured after surgery were included. Surgery revealed 55 lesions (median weight 0.5 g, 11 in ectopy). Sensitivities of US, planar imaging, C-SPECT and P-SPECT were, respectively, 51, 76, 82 and 87%. Nine glands were only detected by tomography and five glands only by P-SPECT. $$ {^{{{\text{99m}}}} {\text{Tc - MIBI}}} \mathord{\left/ {\vphantom {{^{{{\text{99m}}}} {\text{Tc - MIBI}}} {^{{{\text{99m}}}} {\text{TcO}}^{ - }_{{\text{4}}} }}} \right. \kern-\nulldelimiterspace} {^{{{\text{99m}}}} {\text{TcO}}^{ - }_{{\text{4}}} } $$ planar scans and P-SPECT were complementary and, when combined together, showed the highest sensitivity (93%). Compared with planar imaging and C-SPECT, P-SPECT increased CS for 42 and 53% of lesions, respectively, and contributed to markedly reduce the number of uncertain results. A combination of planar $$ {^{{{\text{99m}}}} {\text{Tc - MIBI}}} \mathord{\left/ {\vphantom {{^{{{\text{99m}}}} {\text{Tc - MIBI}}} {^{{{\text{99m}}}} {\text{TcO}}^{ - }_{{\text{4}}} }}} \right. \kern-\nulldelimiterspace} {^{{{\text{99m}}}} {\text{TcO}}^{ - }_{{\text{4}}} } $$ scintigraphy and P-SPECT appears to be a highly accurate preoperative imaging procedure in primary hyperparathyroidism. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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