Iah. Shon et al., The value of oblique pinhole images in pre-operative localisation with Tc-99m-MIBI for primary hyperparathyroidism, EUR J NUCL, 28(6), 2001, pp. 736-742
Citations number
36
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Technetium-99m labelled 2-methoxyisobutylisonitrile (MIBI) has been extensi
vely utilised for preoperative localisation of parathyroid adenomas. Imagin
g techniques have varied widely, with many centres not performing routine o
blique images; thus this study aimed to examine the value of routine obliqu
e pinhole imaging. Ninety-two patients underwent pre-operative Tc-99m-MIBI
imaging including early and delayed anterior oblique pinhole images in addi
tion to standard anterior pinhole images and a thyroid study prior to surge
ry for primary hyperparathyroidism. These studies were reviewed blindly com
paring anterior and oblique images and anterior images only in relation to
surgical findings. Of the 92 patients, 83 were found to have 86 parathyroid
adenomas or parathyroid adenoma/hyperplasia at surgery. When compared to a
nterior images only, oblique views improved overall sensitivity from 76% to
88% (P <0.05), correctly localised II more adenomas than anterior images a
lone (13%) and improved the confidence of interpretation in 17 patients (20
%). In conclusion, routine oblique pinhole views result in greater sensitiv
ity and reporter confidence in pre-operative parathyroid localisation with
Tc-99m-MIBI.