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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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/10/9/639 |
| _version_ | 1797555372188237824 |
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| author | Julie Wulf Christensen Martin Krakauer |
| author_facet | Julie Wulf Christensen Martin Krakauer |
| author_sort | Julie Wulf Christensen |
| collection | DOAJ |
| 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 (<i>p</i> = 0.001). Conclusions: The dual/dual method can be considered superior to the dual/single method in the preoperative imaging in primary hyperparathyroidism. |
| first_indexed | 2024-03-10T16:46:31Z |
| format | Article |
| id | doaj.art-0e92a58303634afda05c67e1f845007c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T16:46:31Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-0e92a58303634afda05c67e1f845007c2023-11-20T11:33:57ZengMDPI AGDiagnostics2075-44182020-08-0110963910.3390/diagnostics10090639Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid ScintigraphyJulie Wulf Christensen0Martin Krakauer1Department of Nuclear Medicine, Herlev and Gentofte Hospital, 2730 Herlev, DenmarkDepartment of Nuclear Medicine, Herlev and Gentofte Hospital, 2730 Herlev, DenmarkBackground: 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 (<i>p</i> = 0.001). Conclusions: The dual/dual method can be considered superior to the dual/single method in the preoperative imaging in primary hyperparathyroidism.https://www.mdpi.com/2075-4418/10/9/639primary hyperparathyroidismdual-isotope subtraction scintigraphydual-isotope subtraction SPECT/CTTc-99m-sestamibi SPECT/CT |
| spellingShingle | Julie Wulf Christensen Martin Krakauer Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy Diagnostics primary hyperparathyroidism dual-isotope subtraction scintigraphy dual-isotope subtraction SPECT/CT Tc-99m-sestamibi SPECT/CT |
| 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 | primary hyperparathyroidism dual-isotope subtraction scintigraphy dual-isotope subtraction SPECT/CT Tc-99m-sestamibi SPECT/CT |
| url | https://www.mdpi.com/2075-4418/10/9/639 |
| work_keys_str_mv | AT juliewulfchristensen addedvalueofsubtractionspectctindualisotopeparathyroidscintigraphy AT martinkrakauer addedvalueofsubtractionspectctindualisotopeparathyroidscintigraphy |