OtherClinical Investigations

The Usefulness of Neck Pinhole SPECT as a Complementary Tool to Planar Scintigraphy in Primary and Secondary Hyperparathyroidism

Angela Spanu, Antonio Falchi, Alessandra Manca, Pietro Marongiu, Antonio Cossu, Nicola Pisu, Francesca Chessa, Susanna Nuvoli and Giuseppe Madeddu
Journal of Nuclear Medicine January 2004, 45 (1) 40-48;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    A 55-y-old female patient affected by pHPT with small parathyroid adenoma (size, 6.1 mm; weight, 261 mg) sited behind inferior pole of right thyroid lobe, negative on planar 99mTc-pertechnetate (A), 99mTc-tetrofosmin (B), and subtraction (C) scintigraphy and clearly revealed (arrow) on coronal P-SPECT (D).

  • FIGURE 2.
    FIGURE 2.

    A 67-y-old male patient affected by sHPT with 4 hyperplastic glands sited behind upper two thirds of right thyroid lobe (size, 6 mm; weight, 274 mg), below inferior pole of right thyroid lobe (size, 15 mm; weight, 685 mg), behind upper two thirds of left thyroid lobe (size, 9 mm; weight, 429 mg), and below inferior pole of left thyroid lobe (size, 17 mm; weight, 850 mg). All glands were clearly revealed (arrows) on different multiple coronal P-SPECT slices (D), whereas planar 99mTc-pertechnetate (A), 99mTc-tetrofosmin (B), and subtraction (C) scintigraphy identified only the 2 sited below inferior pole of 2 thyroid lobes (arrows), missing the other 2, which were smaller in size and weight and were sited behind upper two thirds of 2 thyroid lobes.

  • FIGURE 3.
    FIGURE 3.

    A 65-y-old female patient affected by pHPT with small parathyroid adenoma (size, 6.8 mm; weight, 290 mg) sited behind upper two thirds of left thyroid lobe, positive (arrow) on both early (A) and delayed (B) planar 99mTc-MIBI scintigraphy and on coronal P-SPECT (C), but more clearly visualized by the latter.

Tables

  • TABLE 1

    Histologic Findings in 48 Patients with pHPT (49 Lesions) and in 19 Patients with sHPT (51 Lesions)

    HistologyNo. of lesionsMaximum diameter range (mm)Weight range (mg)
    pHPT
     Solitary adenoma436.1–30261–4,000
     Carcinoma14010,000
     Hyperplastic glands56–18300–900
    sHPT
     Solitary adenoma215–20750–1,060
     Hyperplastic glands496–40210–3,000
  • TABLE 2

    Planar Parathyroid Scintigraphy and Neck P-SPECT Results Related to Histopathologic Findings in Patients with pHPT

    ParameterOverall (n = 49)Adenoma/carcinoma (n = 44)Hyperplasia (n = 5)
    PlanarP-SPECTPlanarP-SPECTPlanarP-SPECT
    TP findings4348404434
    FN findings614021
    Sensitivity (%)87.797.9*90.91006080

    • ↵* P > 0.05 when compared with corresponding planar value (McNemar test results).

    • TP = true-positive; FN = false-negative.

  • TABLE 3

    Planar Parathyroid Scintigraphy and Neck P-SPECT Results Related to Histopathologic Findings in Patients with sHPT

    ParameterOverall (n = 51)Adenoma/carcinoma (n = 2)Hyperplasia (n = 49)
    PlanarP-SPECTPlanarP-SPECTPlanarP-SPECT
    TP findings4047123945
    FN findings11410104
    Sensitivity (%)78.492.1*5010079.691.8

    • ↵* P < 0.05 when compared with corresponding planar value (McNemar test results).

    • TP = true-positive; FN = false-negative.

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools
Bookmark this article

Jump to section