Value of Dual-Phase 99mTc-Sestamibi Scintigraphy With Neck and Thoracic SPECT/CT in Secondary Hyperparathyroidism

Value of Dual-Phase 99mTc-Sestamibi Scintigraphy With Neck and Thoracic SPECT/CT in Secondary Hyperparathyroidism
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颈部和胸部 SPECT/CT 双相 (99m)Tc-sestamibi 闪烁显像在继发性甲状旁腺功能亢进症中的价值。

DOI:
10.2214/ajr.13.11053
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发表时间:
2014-01-01
影响因子:
5
通讯作者:
Zhen, Lishi
Zhen, Lishi
中科院分区:
医学2区
文献类型:
--
作者:
Yang, Jigang;Hao, Ruirui;Zhen, Lishi

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OBJECTIVE Surgical intervention in the form of parathyroidectomy is generally considered only for severe secondary hyperparathyroidism (sHPT). However, correct location of the parathyroid glands before parathyroidectomy is a challenge. The purpose of this study was to compare the diagnostic value of early and delayed phase (99m)Tc-sestamibi SPECT/CT in the detection of parathyroid tissue to guide operative treatment of patients with sHPT. SUBJECTS AND METHODS Eighty patients with sHPT who were undergoing hemodialysis were evaluated preoperatively with dual-phase (99m)Tc-sestamibi SPECT/CT parathyroid scintigraphy to locate parathyroid tissue before parathyroidectomy. The scintigraphic results were classified as positive or negative. The accuracy of (99m)Tc sestamibi early and delayed phase SPECT/CT scintigraphy was determined. RESULTS Early phase (99m)Tc-sestamibi SPECT/CT depicted 3.57 parathyroid glands (PTGs) and delayed phase (99m)Tc-sestamibi SPECT/CT depicted 3.55 PTGs per study. The specificity of both early and delayed phase (99m)Tc-sestamibi SPECT/CT in detecting PTGs was 100%. The (99m)Tc-sestamibi SPECT/CT images of 7 of 80 patients showed positive findings in the delayed phase and negative findings in the early phase. The (99m)Tc-sestamibi SPECT/CT images of 6 of 80 patients showed positive findings in the early phase and negative findings in the delayed phase. CONCLUSION The results of our study indicate that both early and delayed phase (99m)Tc-sestamibi SPECT/CT should be performed in the preoperative evaluation of hemodialysis patients with sHPT due to chronic kidney disease. Performance of both early and delayed phase (99m)Tc-sestamibi SPECT/CT did not increase the radiation dose compared with the use of only the early or the delayed phase.