The value of oblique pinhole images in pre-operative localisation with Tc-99m-MIBI for primary hyperparathyroidism

Citation
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
Journal title
EUROPEAN JOURNAL OF NUCLEAR MEDICINE
ISSN journal
03406997 → ACNP
Volume
28
Issue
6
Year of publication
2001
Pages
736 - 742
Database
ISI
SICI code
0340-6997(200106)28:6<736:TVOOPI>2.0.ZU;2-#
Abstract
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.