Objectives: 1. To assess the sensitivity of scintigraphy using methoxy isobutyl isonitrile (MIBI). 2. To compare its resolution with that of ultrasound (US) and computerized axial tomography (CAT). 3. To use its diagnostic reliability to determine whether selective approaches can be used to treat hyperparathyroidism (HPT).
Patients And Method: A study of 76 patients who underwent surgery for HPT between 1996 and 2005 was performed. MIBI scintigraphy and cervical US were used for whole-body scanning in all patients; CAT was used in 47 patients. Intraoperative and postoperative biopsies were used for final evaluation of the tests, after visualization and surgical extirpation.
Results: The results of scintigraphy were positive in 65 patients (85.52%). The diagnosis was correct in all of the single images. Multiple images were due to hyperplasia and parathyroid adenomas with thyroid disease (5.2%). Three images, incorrectly classified as negative (3.94%), were positive. The sensitivity of US was 63% and allowed detection of three MIBI-negative adenomas (4%). CAT was less sensitive (55%), but detected a further three MIBI-negative adenomas (4%).
Conclusions: 1. The sensitivity of MIBI reached 89.46%. In the absence of thyroid nodules, MIBI diagnosed 100% of single lesions. Pathological thyroid processes produced false-positive results (5.2%) and there were diagnostic errors (4%). 2. MIBI scintigraphy was more sensitive than US and CAT. 3. Positive, single image scintigraphy allows a selective cervical approach. US and CAT may help to save a further 8% of patients (with negative scintigraphy).
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http://dx.doi.org/10.1016/s0009-739x(06)70991-5 | DOI Listing |
Quant Imaging Med Surg
January 2025
Division of Plastic Surgery, Johns Hopkins University, Baltimore, MD, USA.
Background And Objective: Diabetic neuropathy significantly elevates the risk of foot ulceration and lower-limb amputation, underscoring the need for precise assessment of tissue perfusion to optimize management. This narrative review explores the intricate relationship between sympathetic nerves and tissue perfusion in diabetic neuropathy, highlighting the important role of autonomic neuropathy in blood flow dynamics and subsequent compromises in tissue perfusion. The consequences extend to the development of diabetic peripheral neuropathy and related foot complications.
View Article and Find Full Text PDFUpdates Surg
January 2025
Division of General Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
The standardization of preoperative imaging in primary hyperparathyroidism is one of the current challenges of endocrine surgery. A correct localization of the hypersecretory gland by neck ultrasound and 99mTc-sestamibi (MIBI) scintigraphy are not sufficiently sensitive in some cases. In recent years, CT-4D, 18F-Fluorocholine PET/CT, and radio-guided parathyroidectomy have come into common use.
View Article and Find Full Text PDFEur Heart J Imaging Methods Pract
January 2025
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Aims: While most clinical guidelines recommend using a 64-projection view technique, some protocols do not specify a preference between 32-projection and 64-projection methods for conducting myocardial perfusion scintigraphy (MPS), which shows the lack of consensus in this matter. Nevertheless, these guidelines and protocols have not provided us with compelling evidence to support why the 64-projection technique is usually chosen. Thus, we aimed to determine if there is a significant difference between them in the assessment of cardiac perfusion and functional indices.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Nuclear Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Purpose: Parathyroid carcinoma (PC) is an extremely rare disease, typically presenting with marked elevations of serum calcium concentrations and associated with significantly increased parathyroid hormone (PTH) levels. Although it progresses slowly, approximately25% of PC patients have lung metastases. In the present study, we aimed to evaluate the role of technetium-99m methoxy isobutyl isonitrile (Tc-99m-MIBI; sestamibi) SPECT/CT scintigraphy in the preoperative localization of parathyroid adenomas, incidental metastases findings of PC, and ectopic parathyroid tissue.
View Article and Find Full Text PDFBest Pract Res Clin Endocrinol Metab
December 2024
Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. Electronic address:
Primary hyperparathyroidism is the main cause of hypercalcemia, resulting predominantly from parathyroid adenomas followed by hyperplasia. Diagnosis relies on clinical and biochemical parameters. Accurate pre-operative localization is mandatory for better surgical outcome.
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