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Accuracy of early‐phase versus dual‐phase single‐photon emission computed tomography/computed tomography in the localization of Parathyroid disease
Author(s) -
Mandal Rajarsi,
Muthukrishnan Ashok,
Ferris Robert L.,
de Almeida John R.,
Duvvuri Umamaheswar
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25020
Subject(s) - medicine , single photon emission computed tomography , radiology , nuclear medicine , tomography , parathyroid adenoma , adenoma , pathology
Objectives/Hypothesis Preoperative localization for parathyroid disease has improved in recent years with the advent of dual‐phase 99m Tc‐sestamibi single‐photon emission computed tomography/computed tomography (SPECT/CT) imaging. However, dual‐phase imaging is associated with increased cost, time, and radiation dose. The aim of this study was to investigate the need for late‐phase imaging when using SPECT/CT for the preoperative localization of parathyroid disease. Study Design Retrospective chart analysis. Methods A retrospective review of 75 patients who underwent preoperative imaging localization and subsequent surgical resection for parathyroid disease at a tertiary referral center was performed. Of these, 50 patients met study criteria including preoperative SPECT/CT imaging and specific reporting of early‐ and late‐phase focal radiotracer uptake. Localization accuracy was verified with definitive surgical findings confirmed by histological analysis and evidence of biochemical cure. Results Accurate localization of adenoma(s) was seen in 78.0% of patients using dual‐phase SPECT/CT. Early‐phase imaging alone localized 76.0%, whereas late‐phase imaging alone localized 74.0%. Sensitivity and specificity for dual‐phase imaging was 84.8% and 89.6%, respectively. In comparison, early‐phase localization alone was found to have a sensitivity/specificity of 84.4%/89.4%; sensitivity/specificity of late‐phase scanning alone was found to be 80.4%/89.1%. Dual‐phase SPECT/CT scanning did not provide a statistically significant improvement in adenoma localization when compared to early‐phase scanning alone. Conclusions Although further investigation is needed, the results of this study suggest that early‐phase SPECT/CT scanning alone may obviate the need for dual‐phase SPECT/CT scanning in the initial preoperative localization workup of parathyroid disease. Level of Evidence 4. Laryngoscope , 125:1496–1501, 2015