title: Value of dual-phase (99m)Tc-sestamibi scintigraphy with neck and thoracic SPECT/CT in secondary hyperparathyroidism.
abstract: OBJECTIVE
  Surgical intervention in the form of parathyroidectomy is generally considered only for severe secondary hyperparathyroidism (sHPT). However, correct location of the parathyroid glands before parathyroidectomy is a challenge. The purpose of this study was to compare the diagnostic value of early and delayed phase (99m)Tc-sestamibi SPECT/CT in the detection of parathyroid tissue to guide operative treatment of patients with sHPT.
  
  
  METHODS
  Eighty patients with sHPT who were undergoing hemodialysis were evaluated preoperatively with dual-phase (99m)Tc-sestamibi SPECT/CT parathyroid scintigraphy to locate parathyroid tissue before parathyroidectomy. The scintigraphic results were classified as positive or negative. The accuracy of (99m)Tc sestamibi early and delayed phase SPECT/CT scintigraphy was determined.
  
  
  RESULTS
  Early phase (99m)Tc-sestamibi SPECT/CT depicted 3.57 parathyroid glands (PTGs) and delayed phase (99m)Tc-sestamibi SPECT/CT depicted 3.55 PTGs per study. The specificity of both early and delayed phase (99m)Tc-sestamibi SPECT/CT in detecting PTGs was 100%. The (99m)Tc-sestamibi SPECT/CT images of 7 of 80 patients showed positive findings in the delayed phase and negative findings in the early phase. The (99m)Tc-sestamibi SPECT/CT images of 6 of 80 patients showed positive findings in the early phase and negative findings in the delayed phase.
  
  
  CONCLUSIONS
  The results of our study indicate that both early and delayed phase (99m)Tc-sestamibi SPECT/CT should be performed in the preoperative evaluation of hemodialysis patients with sHPT due to chronic kidney disease. Performance of both early and delayed phase (99m)Tc-sestamibi SPECT/CT did not increase the radiation dose compared with the use of only the early or the delayed phase.
authors.affiliation: 1 Department of Nuclear Medicine, Beijing Friendship Hospital of Capital Medical University, 95 Yong An Rd, XiCheng District, Beijing 100050, PR China.
authors.forename: Jigang
authors.initials: J
authors.lastname: Yang
authors.forename: Ruirui
authors.initials: R
authors.lastname: Hao
authors.forename: Leilei
authors.initials: L
authors.lastname: Yuan
authors.forename: Chunlin
authors.initials: C
authors.lastname: Li
authors.forename: Jue
authors.initials: J
authors.lastname: Yan
authors.forename: Lishi
authors.initials: L
authors.lastname: Zhen
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D064847:Multimodal Imaging; D009333:Neck / Q000000981:diagnostic imaging; D016105:Parathyroidectomy; D013902:Radiography, Thoracic; D019275:Radiopharmaceuticals; D006435:Renal Dialysis; D017256:Technetium Tc 99m Sestamibi; D013909:Thorax / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi