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Nuclear Medicine and Molecular Imaging

Published in:

01-03-2017 | Original Article

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal ^99mTc-Sestamibi Retention

Authors: Sang Hyun Hwang, Yumie Rhee, Mijin Yun, Jung Hyun Yoon, Jeong Won Lee, Arthur Cho

Published in: Nuclear Medicine and Molecular Imaging | Issue 1/2017

Abstract

Purpose

Parathyroid adenoma detection with dual-phase ^99mTc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection. We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients.

Methods

Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CT was performed immediately after delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention.

Results

In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CT-HU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention.

Conclusion

AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.

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Title: Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention
Authors: Sang Hyun Hwang
Yumie Rhee
Mijin Yun
Jung Hyun Yoon
Jeong Won Lee
Arthur Cho
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Nuclear Medicine and Molecular Imaging / Issue 1/2017
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI: https://doi.org/10.1007/s13139-016-0438-5

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Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal ^99mTc-Sestamibi Retention

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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