Parathyroid Detection in Secondary Hyperparathyroidism with123I/99mTc-Sestamibi Subtraction Single Photon Emission Computed Tomography
| Autor: | Esselstyn Cb, Donald R. Neumann, C O Wong, Lieber M, Madera A |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adenoma
Adult Male Technetium Tc 99m Sestamibi medicine.medical_specialty Endocrinology Diabetes and Metabolism Clinical Biochemistry Single-photon emission computed tomography Sensitivity and Specificity Biochemistry Technetium (99mTc) sestamibi Iodine Radioisotopes Parathyroid Glands Endocrinology Internal medicine Spect imaging medicine Humans Tomography Emission-Computed Single-Photon Hyperparathyroidism medicine.diagnostic_test business.industry Biochemistry (medical) Subtraction Middle Aged medicine.disease Parathyroid Neoplasms medicine.anatomical_structure Kidney Failure Chronic Female Hyperparathyroidism Secondary Secondary hyperparathyroidism Parathyroid gland Radiopharmaceuticals business medicine.drug Kidney disease |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 83:3867-3871 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | 123I/99mTc-sestamibi subtraction single photon emission computed tomography (SPECT) has been proposed to detect hyperplastic parathyroid tissue, but the clinical usefulness of this technique in secondary hyperparathyroidism is uncertain. The purpose of this study was to evaluate preoperative parathyroid localization using 123I/99mTc-sestamibi subtraction SPECT in patients with renal failure and secondary hyperparathyroidism. Nineteen patients with chronic renal failure and secondary hyperparathyroidism underwent 123I/99mTc-sestamibi subtraction SPECT imaging preoperatively. None of these patients had undergone previous neck surgery. The location, weight, and histopathological results of all identified parathyroid glands were recorded. Surgery was considered successful in all patients, with resection of a total of 74 hyperplastic parathyroid glands. 123I/99mTc-sestamibi subtraction SPECT correctly identified 57 of these parathyroid glands (77% sensitivity). The mean weight among the true positive glands (n = 57) was 1031 mg (range, 45-7900 mg), and that among the false negative glands (n = 17) was 465 mg (range, 20-1800 mg). This difference between the mean weights was statistically significant (P = 0.018). There was a positive correlation between parathyroid weight and detectability with 123I/99mTc-sestamibi subtraction SPECT (Spearman correlation = 0.28; P = 0.0167). 123I/99mTc-sestamibi subtraction SPECT is able to correctly localize hyperplastic parathyroid glands in patients with renal failure and secondary hyperparathyroidism, but there is a fairly weak relationship between preoperative detection rate and anatomical parathyroid gland size. |
| Databáze: | OpenAIRE |
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