Conference Presentations by Kijja Rhoongsittichai
AOCMP, 2020
Introduction: Preoperative imaging is usually performed to localize the hyper-functioning parathy... more Introduction: Preoperative imaging is usually performed to localize the hyper-functioning parathyroid glands to facilitate a minimally invasive surgical approach. Parathyroid scintigraphy has been the investigation of choice for decades. However, it is still in doubt that which technique is the best. Purpose: To evaluate the diagnostic performance of dual-tracer subtraction (DT), dual-phase 99mTc-MIBI (DP), and 99mTc-MIBI SPECT/CT parathyroid scintigraphy for preoperative localization in patients with hyperparathyroidism. Methods: This is a retrospective study of 481 consecutive patients with biochemically confirmed hyperparathyroidism who were referred for parathyroid scintigraphy. All patients had routinely underwent three techniques of parathyroid scintigraphy; i.e. DT, DP, and 99mTc-MIBI SPECT/CT. One hundred patients, who had complete imaging data and had pathologically confirmed diagnosis within eight months, were included for the analysis. All the parathyroid scintigraphy images retrieved from the PACS system were blindly reinterpreted by two nuclear medicine physicians at least three weeks apart for each imaging set. A consensus interpretation was made if the readings were distinct. Results: A total of 243 parathyroid lesions were analyzed, consisting of 205 hyperplastic glands, 28 adenomas, and two carcinomas. The remaining eight foci reveal a normal parathyroid gland. According to the lesion-based analysis, the overall pooled sensitivities for DT, DP, and SPECT/CT were 48.09%, 39.57%, and 53.19%, respectively. However, subgroup analysis showed better sensitivities for parathyroid adenoma of 82.14%, 78.57%, 92.86% than those for hyperplastic glands of 42.93%, 33.66%, 47.32%, respectively. A comparison between techniques of parathyroid scintigraphy revealed statistically significant differences between DT and DP (p = 0.01) and between DP and SPECT/CT (p < 0.001) but there was no statistically significant difference between DT and SPECT/CT (p = 0.182). Conclusion: Parathyroid scintigraphy has higher sensitivity for parathyroid adenoma rather than hyperplastic glands in all three techniques. DT and SPECT/CT techniques provide similar sensitivities and are superior to DP technique.
Papers by Kijja Rhoongsittichai
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Conference Presentations by Kijja Rhoongsittichai
Papers by Kijja Rhoongsittichai