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Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy

Background: Adding subtraction single-photon emission computed tomography/computed tomography (SPECT/CT) to dual isotope (I-123 and Tc-99m-sestamibi) subtraction parathyroid scintigraphy is not widely implemented. We aimed to assess the added value of dual isotope subtraction SPECT/CT over single is...

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Autores principales: Christensen, Julie Wulf, Krakauer, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555464/
https://www.ncbi.nlm.nih.gov/pubmed/32867155
http://dx.doi.org/10.3390/diagnostics10090639
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author Christensen, Julie Wulf
Krakauer, Martin
author_facet Christensen, Julie Wulf
Krakauer, Martin
author_sort Christensen, Julie Wulf
collection PubMed
description Background: Adding subtraction single-photon emission computed tomography/computed tomography (SPECT/CT) to dual isotope (I-123 and Tc-99m-sestamibi) subtraction parathyroid scintigraphy is not widely implemented. We aimed to assess the added value of dual isotope subtraction SPECT/CT over single isotope SPECT/CT as an adjunct to dual isotope planar pinhole subtraction scintigraphy. Methods: Parathyroid scintigraphies from 106 patients with an estimated total of 415 parathyroid glands who (1) were diagnosed with primary hyperparathyroidism, (2) underwent dual isotope subtraction scintigraphy in the Department of Nuclear Medicine, Gentofte Hospital, Denmark throughout 2017 and (3) underwent subsequent parathyroidectomy, were included. The original dual isotope planar pinhole subtraction plus dual isotope subtraction SPECT/CT (dual/dual method) exams were retrospectively re-evaluated using only Tc-99m-sestamibi SPECT/CT (dual/single method). Statistics were calculated per parathyroid. Surgical results confirmed by pathology served as reference standard. Results: The dual/dual method had higher sensitivity than the dual/single method (82% (95%CI 74%–88%) vs. 69% (95%CI 60%–77%)) while specificity, positive and negative predictive values (PPV and NPV) were similar (specificity 96% vs. 93%, PPV’s 87% vs. 82% and NPV’s 89% vs. 93%). Reader confidence was higher when employing the dual/dual method (p = 0.001). Conclusions: The dual/dual method can be considered superior to the dual/single method in the preoperative imaging in primary hyperparathyroidism.
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spelling pubmed-75554642020-10-19 Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy Christensen, Julie Wulf Krakauer, Martin Diagnostics (Basel) Article Background: Adding subtraction single-photon emission computed tomography/computed tomography (SPECT/CT) to dual isotope (I-123 and Tc-99m-sestamibi) subtraction parathyroid scintigraphy is not widely implemented. We aimed to assess the added value of dual isotope subtraction SPECT/CT over single isotope SPECT/CT as an adjunct to dual isotope planar pinhole subtraction scintigraphy. Methods: Parathyroid scintigraphies from 106 patients with an estimated total of 415 parathyroid glands who (1) were diagnosed with primary hyperparathyroidism, (2) underwent dual isotope subtraction scintigraphy in the Department of Nuclear Medicine, Gentofte Hospital, Denmark throughout 2017 and (3) underwent subsequent parathyroidectomy, were included. The original dual isotope planar pinhole subtraction plus dual isotope subtraction SPECT/CT (dual/dual method) exams were retrospectively re-evaluated using only Tc-99m-sestamibi SPECT/CT (dual/single method). Statistics were calculated per parathyroid. Surgical results confirmed by pathology served as reference standard. Results: The dual/dual method had higher sensitivity than the dual/single method (82% (95%CI 74%–88%) vs. 69% (95%CI 60%–77%)) while specificity, positive and negative predictive values (PPV and NPV) were similar (specificity 96% vs. 93%, PPV’s 87% vs. 82% and NPV’s 89% vs. 93%). Reader confidence was higher when employing the dual/dual method (p = 0.001). Conclusions: The dual/dual method can be considered superior to the dual/single method in the preoperative imaging in primary hyperparathyroidism. MDPI 2020-08-27 /pmc/articles/PMC7555464/ /pubmed/32867155 http://dx.doi.org/10.3390/diagnostics10090639 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Christensen, Julie Wulf
Krakauer, Martin
Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy
title Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy
title_full Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy
title_fullStr Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy
title_full_unstemmed Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy
title_short Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy
title_sort added value of subtraction spect/ct in dual-isotope parathyroid scintigraphy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7555464/
https://www.ncbi.nlm.nih.gov/pubmed/32867155
http://dx.doi.org/10.3390/diagnostics10090639
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