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

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@article{8cac2fc790b343af988975981e8e3d71,
title = "Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy",
abstract = "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.",
keywords = "Dual-isotope subtraction SPECT/CT, Dual-isotope subtraction scintigraphy, Primary hyperparathyroidism, Tc-99m-sestamibi SPECT/CT, dual-isotope subtraction SPECT/CT, primary hyperparathyroidism, dual-isotope subtraction scintigraphy",
author = "Christensen, {Julie Wulf} and Martin Krakauer",
note = "Publisher Copyright: {\textcopyright} 2020 by the authors. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
month = aug,
day = "27",
doi = "10.3390/diagnostics10090639",
language = "English",
volume = "10",
journal = "Diagnostics",
issn = "2075-4418",
publisher = "M D P I AG",
number = "9",

}

RIS

TY - JOUR

T1 - Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy

AU - Christensen, Julie Wulf

AU - Krakauer, Martin

N1 - Publisher Copyright: © 2020 by the authors. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/8/27

Y1 - 2020/8/27

N2 - 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.

AB - 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.

KW - Dual-isotope subtraction SPECT/CT

KW - Dual-isotope subtraction scintigraphy

KW - Primary hyperparathyroidism

KW - Tc-99m-sestamibi SPECT/CT

KW - dual-isotope subtraction SPECT/CT

KW - primary hyperparathyroidism

KW - dual-isotope subtraction scintigraphy

U2 - 10.3390/diagnostics10090639

DO - 10.3390/diagnostics10090639

M3 - Journal article

C2 - 32867155

VL - 10

JO - Diagnostics

JF - Diagnostics

SN - 2075-4418

IS - 9

M1 - 639

ER -

ID: 61946632