title: Early and delayed pinhole MIBI SPECT in detecting hyperfunctioning parathyroid glands: a comparison with peroperative γ probe.
abstract: OBJECTIVE
  This study was conducted to evaluate the early and delayed pinhole MIBI single photon emission computed tomography (pSPECT) images in detecting hyperfunctioning parathyroid glands, to make a comparison with peroperative γ probe (GP) findings.
  
  
  METHODS
  Planar, early, and delayed pSPECT scans and skin in-vivo and ex-vivo GP counts were obtained in 22 patients with hyperparathyroidism. All data were analyzed statistically on the basis of localization of the lesions, using the histopathological findings as the gold standard.
  
  
  RESULTS
  Histopathological examinations revealed 18 of 44 adenomas, 18 of 44 hyperplasic glands, two of 44 lymph nodules, five of 44 thyroid nodules, and one of 44 normal parathyroid glands. Sensitivity and specificity were found to be 36 and 100% for planar, 69 and 75% for early pSPECT, 86 and 88% for delayed pSPECT scans, and similarly, 78 and 75% on skin, 92 and 75% in-vivo and 83 and 100% ex-vivo GP counts, respectively. For distinction ability of GP counts between three groups of lesions, there was a statistically significant difference among the three groups for ex-vivo GP counts but not between groups of adenomas and hyperplasic lesions for in-vivo GP counts.
  
  
  CONCLUSIONS
  Early and delayed pSPECT scans play a complementary role on the planar scans. Delayed pSPECT scans and in-vivo GP counts are equally valuable to localize both single and multiple hyperfunctioning parathyroid glands. Ex-vivo GP counts seem to be better for making a distinction among types of lesions.
authors.affiliation: Division of Nuclear Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. gultekinsinan@gmail.com
authors.forename: Salih Sinan
authors.initials: SS
authors.lastname: Gültekin
authors.forename: Metin
authors.initials: M
authors.lastname: Kir
authors.forename: Tuğbay
authors.initials: T
authors.lastname: Tuğ
authors.forename: Seher
authors.initials: S
authors.lastname: Demirer
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Genç
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D057234:Preoperative Period; D012588:Scintillation Counting / Q000295:instrumentation / Q000379:methods*; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D055815:Young Adult
chemical_list: D017256:Technetium Tc 99m Sestamibi