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Master Thesis

Performances de la scintigraphie parathyroïdienne (l123/Tc99m Sestamibi) avec soustraction tomoscintigraphique dans l'hyperparathyroïdie primaire

Abstract : Purpose: Primary hyperparathyroidism (PHP) is one of the most common endocrinological conditions especially with an increasingly aging population. Surgery remains the only curative option and can be tailored according to the number and location of abnormally functioning parathyroid glands. The objective is to evaluate the performance of double isotope 123I/99mTc-sestamibi parathyroid scintigraphy with subtraction SPECT/CT in primary hyperparathyroidism for identifying uniglandular disease that can benefit from minimally invasive approaches. Materials and Methods: Ninety PHP patients that had undergone preoperative imaging studies and parathyroidectomy at Marseille University Hospital between December 2015 and August 2016 were included in this study. All patients were evaluated with neck ultrasound (US), parathyroid scintigraphy (PS) including double isotope 123I/99mTc-sestamibi subtraction planar pinhole and SPECT/CT with a new protocol. Outcomes from imaging modalities were reported as: uniglandular disease (UGD), multiglandular disease (MGD), or negative, and were compared to final diagnoses post-operatively. Results: Post-operatively, 72 and 18 patients had true UGD and MGD, respectively. Sensitivities and specificities of US, pinhole scintigraphy with subtraction, pinhole and SPECT/CT with subtraction, and all modalities combined were 91.7%/38.9%, 88.9%/72.2%, 93%/66.7% and 84.72%/77.78%, respectively (specificity of US+PS being superior to US alone, p=0.023). SPECT/CT enables reclassification of doubtful uptake foci on pinhole. Conclusions: Combination of neck US and PS with subtraction SPECT/CT offers a higher specificity for guiding towards minimally invasive parathyroidectomy.
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https://dumas.ccsd.cnrs.fr/dumas-01875191
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Submitted on : Monday, September 17, 2018 - 10:00:17 AM
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Paulina Asseeva-Kuhner. Performances de la scintigraphie parathyroïdienne (l123/Tc99m Sestamibi) avec soustraction tomoscintigraphique dans l'hyperparathyroïdie primaire. Sciences du Vivant [q-bio]. 2017. ⟨dumas-01875191⟩

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