title: SPECT/CT in localization of parathyroid adenoma or hyperplasia in patients with previous neck surgery.
abstract: OBJECTIVE
  Single photon emission computed tomography/computed tomography (SPECT/CT) now makes it possible to use combined morphologic CT and functional scintigraphy information. It has proved useful for localization of abnormal parathyroid glands, especially in the case of an ectopic gland. We experienced that it was also beneficial for patients with a history of previous neck surgery, and we report 4 cases in this entity.
  
  
  METHODS
  Four patients with prior neck surgery and hyperparathyroidism underwent parathyroid Tc-99m MIBI scintigraphy with SPECT/CT. Two patients had undergone surgery for hyperparathyroidism and 2 had undergone thyroidectomy, 1 for thyroid cancer and 1 for multinodular goiter. Parathyroid hormone levels were assessed during surgery, and patients were followed several months after treatment.
  
  
  RESULTS
  SPECT/CT successfully localized the abnormal gland, including an uncommon anterior situation for which previous surgery guided by planar imagery failed to cure the hyperparathyroidism. It allowed efficient surgical treatment, as confirmed by parathyroid hormone level normalization, without complications and with a relatively short operation time in those challenging cases.
  
  
  CONCLUSIONS
  SPECT/CT seems to be a useful tool for presurgical assessment in hyperparathyroidism, not only for ectopic glands but also for patients with previous neck surgery.
authors.affiliation: Service de Médecine Nucléaire, Institut Jean Godinot, Centre Hospitalier et Universitaire de Reims, France. d.papathanassiou@reims.fnclcc.fr
authors.forename: Dimitri
authors.initials: D
authors.lastname: Papathanassiou
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Flament
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Pochart
authors.forename: Martine
authors.initials: M
authors.lastname: Patey
authors.forename: Hélène
authors.initials: H
authors.lastname: Marty
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Liehn
authors.forename: Claire
authors.initials: C
authors.lastname: Schvartz
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D013965:Thyroidectomy; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*