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Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Authors
 Sang Hyun Hwang  ;  Yumie Rhee  ;  Mijin Yun  ;  Jung Hyun Yoon  ;  JeongWon Lee  ;  Arthur Cho 
Citation
 Nuclear Medicine and Molecular Imaging, Vol.51(1) : 32-39, 2017 
Journal Title
 Nuclear Medicine and Molecular Imaging 
ISSN
 1869-3474 
Issue Date
2017
Keywords
99mTc-sestamibi scintigraphy ; Autoimmune thyroid disease ; Parathyroid ; SPECT/CT
Abstract
PURPOSE: Parathyroid adenoma detection with dual-phase 99mTc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection. We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients. METHODS: Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CT was performed immediately after delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention. RESULTS: In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CT-HU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention. CONCLUSION: AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.
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DOI
10.1007/s13139-016-0438-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166034
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