Accuracy of technetium-99m SPECT-CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas
✍ Scribed by Luke Harris; John Yoo; Albert Driedger; Kevin Fung; Jason Franklin; Daryl Gray; Ronald Holliday
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 323 KB
- Volume
- 30
- Category
- Article
- ISSN
- 1043-3074
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✦ Synopsis
Abstract
Background.
This study evaluated the accuracy of single photon emission computed tomography (SPECT)‐CT imaging for the preoperative localization of parathyroid adenomas.
Methods.
This study included both a quantitative and qualitative accuracy measure. The quantitative measure was the distance between the location of the adenoma on the SPECT‐CT scan and the location of the adenoma intraoperatively. Qualitatively, surgeons were asked whether or not the adenoma was in the exact location predicted by the SPECT‐CT scan. The time from initial incision to identification of the parathyroid was recorded. Patients referred to London Health Sciences Centre for a suspected parathyroid adenoma were eligible for this study.
Results.
Twenty‐three patients participated in this study. Eighteen (78.3%) had a single adenoma, 2 (8.7%) had double adenomas, and 3 (13.0%) had multiglandular hyperplasia. SPECT‐CT correctly detected and localized 16 of 18 (88.9%) cases of single parathyroid adenomas. The mean distance between the location of the adenoma on the SPECT‐CT scan and the location of the adenoma intraoperatively was 16.3 mm (95% ≤ 19.0 mm). For single adenomas, the median time from skin incision to identification was 14 minutes (range, 8–40 minutes). The preoperative detection and localization of a single focus of sestamibi uptake yielded a parathyroid adenoma in the specified location in 80.0% of cases (95% CI, 97.4–66.5%).
Conclusions.
SPECT‐CT predicted the intraoperative location of a single parathyroid adenoma within 19.0 mm with 95% confidence. The correct detection and localization of multiglandular disease remains difficult. © 2007 Wiley Periodicals, Inc. Head Neck, 2008