Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions

Salvatore Mazzeo, Davide Caramella, Riccardo Lencioni, Nicola Molea, Annalisa De Liperi, Claudio Marcocci, Paolo Miccoli, Pietro Iacconi, Gabriella Bruno Bossio, Paolo Viacava, Elena Lazzeri, Carlo Bartolozzi

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

OBJECTIVE. This study prospectively evaluated the sensitivity of high- resolution sonography compared with double-tracer 201Tl-99mTc scintigraphy (Tl-Tc) subtractive scintigraphy and double-phase 99mTc- sestamibi (Tc-MIBI) scintigraphy prior to surgery in the assessment of patients with primary hyperparathyroidism in a geographic region where areas of endemic thyroid goiter are present. SUBJECTS AND METHODS. Sonography and scintigraphy were used as first-step imaging procedures in 73 patients with primary hyperparathyroidism. In 30 (41%) of 73 cases, we found an association with a thyroid abnormality. We compared sonography with double-tracer Tl-Tc scintigraphy in 41 cases, with Tc-MIBI scintigraphy in 22 other cases, and with both scintigraphic studies in 10 other cases. RESULTS. Surgery demonstrated 68 solitary parathyroid lesions (66 adenomas, one hyperplasia, and one carcinoma), two adenomas in two patients, and multiple hyperplastic glands in two patients for a total of seven lesions. In one case no abnormal parathyroid gland was found. Overall sensitivity of sonography, Tl-Tc, and Tc-MIBI scintigraphy was 85%, 62%, and 82%, respectively. In patients with concomitant thyroid disease, the sensitivity of sonography, dual-tracer Tl- Tc, and Tc-MIBI was 77%, 67%, and 80%, respectively. CONCLUSION. Our study proves that sonography and scintigraphy are equally able to detect parathyroid lesions before surgery in patients with concomitant thyroid diseases. In patients without thyroid abnormalities, detection rates of sonography and Tc-MIBI do not show any statistical difference, and the detection rate of Tl-Tc is significantly inferior to that of sonography. Sonography alone should be used as the first step for localization of abnormal parathyroid glands prior to surgery, and Tc-MIBI scintigraphy should be used as the second step when sonography is negative.

Original languageEnglish (US)
Pages (from-to)1465-1470
Number of pages6
JournalAmerican Journal of Roentgenology
Volume166
Issue number6
StatePublished - Jun 1996
Externally publishedYes

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Radionuclide Imaging
Technetium Tc 99m Sestamibi
Ultrasonography
Thyroid Gland
Parathyroid Glands
Primary Hyperparathyroidism
Thyroid Diseases
Adenoma
Endemic Goiter
Hyperplasia
Carcinoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Mazzeo, S., Caramella, D., Lencioni, R., Molea, N., De Liperi, A., Marcocci, C., ... Bartolozzi, C. (1996). Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions. American Journal of Roentgenology, 166(6), 1465-1470.

Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions. / Mazzeo, Salvatore; Caramella, Davide; Lencioni, Riccardo; Molea, Nicola; De Liperi, Annalisa; Marcocci, Claudio; Miccoli, Paolo; Iacconi, Pietro; Bossio, Gabriella Bruno; Viacava, Paolo; Lazzeri, Elena; Bartolozzi, Carlo.

In: American Journal of Roentgenology, Vol. 166, No. 6, 06.1996, p. 1465-1470.

Research output: Contribution to journalArticle

Mazzeo, S, Caramella, D, Lencioni, R, Molea, N, De Liperi, A, Marcocci, C, Miccoli, P, Iacconi, P, Bossio, GB, Viacava, P, Lazzeri, E & Bartolozzi, C 1996, 'Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions', American Journal of Roentgenology, vol. 166, no. 6, pp. 1465-1470.
Mazzeo, Salvatore ; Caramella, Davide ; Lencioni, Riccardo ; Molea, Nicola ; De Liperi, Annalisa ; Marcocci, Claudio ; Miccoli, Paolo ; Iacconi, Pietro ; Bossio, Gabriella Bruno ; Viacava, Paolo ; Lazzeri, Elena ; Bartolozzi, Carlo. / Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions. In: American Journal of Roentgenology. 1996 ; Vol. 166, No. 6. pp. 1465-1470.
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abstract = "OBJECTIVE. This study prospectively evaluated the sensitivity of high- resolution sonography compared with double-tracer 201Tl-99mTc scintigraphy (Tl-Tc) subtractive scintigraphy and double-phase 99mTc- sestamibi (Tc-MIBI) scintigraphy prior to surgery in the assessment of patients with primary hyperparathyroidism in a geographic region where areas of endemic thyroid goiter are present. SUBJECTS AND METHODS. Sonography and scintigraphy were used as first-step imaging procedures in 73 patients with primary hyperparathyroidism. In 30 (41{\%}) of 73 cases, we found an association with a thyroid abnormality. We compared sonography with double-tracer Tl-Tc scintigraphy in 41 cases, with Tc-MIBI scintigraphy in 22 other cases, and with both scintigraphic studies in 10 other cases. RESULTS. Surgery demonstrated 68 solitary parathyroid lesions (66 adenomas, one hyperplasia, and one carcinoma), two adenomas in two patients, and multiple hyperplastic glands in two patients for a total of seven lesions. In one case no abnormal parathyroid gland was found. Overall sensitivity of sonography, Tl-Tc, and Tc-MIBI scintigraphy was 85{\%}, 62{\%}, and 82{\%}, respectively. In patients with concomitant thyroid disease, the sensitivity of sonography, dual-tracer Tl- Tc, and Tc-MIBI was 77{\%}, 67{\%}, and 80{\%}, respectively. CONCLUSION. Our study proves that sonography and scintigraphy are equally able to detect parathyroid lesions before surgery in patients with concomitant thyroid diseases. In patients without thyroid abnormalities, detection rates of sonography and Tc-MIBI do not show any statistical difference, and the detection rate of Tl-Tc is significantly inferior to that of sonography. Sonography alone should be used as the first step for localization of abnormal parathyroid glands prior to surgery, and Tc-MIBI scintigraphy should be used as the second step when sonography is negative.",
author = "Salvatore Mazzeo and Davide Caramella and Riccardo Lencioni and Nicola Molea and {De Liperi}, Annalisa and Claudio Marcocci and Paolo Miccoli and Pietro Iacconi and Bossio, {Gabriella Bruno} and Paolo Viacava and Elena Lazzeri and Carlo Bartolozzi",
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T1 - Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions

AU - Mazzeo, Salvatore

AU - Caramella, Davide

AU - Lencioni, Riccardo

AU - Molea, Nicola

AU - De Liperi, Annalisa

AU - Marcocci, Claudio

AU - Miccoli, Paolo

AU - Iacconi, Pietro

AU - Bossio, Gabriella Bruno

AU - Viacava, Paolo

AU - Lazzeri, Elena

AU - Bartolozzi, Carlo

PY - 1996/6

Y1 - 1996/6

N2 - OBJECTIVE. This study prospectively evaluated the sensitivity of high- resolution sonography compared with double-tracer 201Tl-99mTc scintigraphy (Tl-Tc) subtractive scintigraphy and double-phase 99mTc- sestamibi (Tc-MIBI) scintigraphy prior to surgery in the assessment of patients with primary hyperparathyroidism in a geographic region where areas of endemic thyroid goiter are present. SUBJECTS AND METHODS. Sonography and scintigraphy were used as first-step imaging procedures in 73 patients with primary hyperparathyroidism. In 30 (41%) of 73 cases, we found an association with a thyroid abnormality. We compared sonography with double-tracer Tl-Tc scintigraphy in 41 cases, with Tc-MIBI scintigraphy in 22 other cases, and with both scintigraphic studies in 10 other cases. RESULTS. Surgery demonstrated 68 solitary parathyroid lesions (66 adenomas, one hyperplasia, and one carcinoma), two adenomas in two patients, and multiple hyperplastic glands in two patients for a total of seven lesions. In one case no abnormal parathyroid gland was found. Overall sensitivity of sonography, Tl-Tc, and Tc-MIBI scintigraphy was 85%, 62%, and 82%, respectively. In patients with concomitant thyroid disease, the sensitivity of sonography, dual-tracer Tl- Tc, and Tc-MIBI was 77%, 67%, and 80%, respectively. CONCLUSION. Our study proves that sonography and scintigraphy are equally able to detect parathyroid lesions before surgery in patients with concomitant thyroid diseases. In patients without thyroid abnormalities, detection rates of sonography and Tc-MIBI do not show any statistical difference, and the detection rate of Tl-Tc is significantly inferior to that of sonography. Sonography alone should be used as the first step for localization of abnormal parathyroid glands prior to surgery, and Tc-MIBI scintigraphy should be used as the second step when sonography is negative.

AB - OBJECTIVE. This study prospectively evaluated the sensitivity of high- resolution sonography compared with double-tracer 201Tl-99mTc scintigraphy (Tl-Tc) subtractive scintigraphy and double-phase 99mTc- sestamibi (Tc-MIBI) scintigraphy prior to surgery in the assessment of patients with primary hyperparathyroidism in a geographic region where areas of endemic thyroid goiter are present. SUBJECTS AND METHODS. Sonography and scintigraphy were used as first-step imaging procedures in 73 patients with primary hyperparathyroidism. In 30 (41%) of 73 cases, we found an association with a thyroid abnormality. We compared sonography with double-tracer Tl-Tc scintigraphy in 41 cases, with Tc-MIBI scintigraphy in 22 other cases, and with both scintigraphic studies in 10 other cases. RESULTS. Surgery demonstrated 68 solitary parathyroid lesions (66 adenomas, one hyperplasia, and one carcinoma), two adenomas in two patients, and multiple hyperplastic glands in two patients for a total of seven lesions. In one case no abnormal parathyroid gland was found. Overall sensitivity of sonography, Tl-Tc, and Tc-MIBI scintigraphy was 85%, 62%, and 82%, respectively. In patients with concomitant thyroid disease, the sensitivity of sonography, dual-tracer Tl- Tc, and Tc-MIBI was 77%, 67%, and 80%, respectively. CONCLUSION. Our study proves that sonography and scintigraphy are equally able to detect parathyroid lesions before surgery in patients with concomitant thyroid diseases. In patients without thyroid abnormalities, detection rates of sonography and Tc-MIBI do not show any statistical difference, and the detection rate of Tl-Tc is significantly inferior to that of sonography. Sonography alone should be used as the first step for localization of abnormal parathyroid glands prior to surgery, and Tc-MIBI scintigraphy should be used as the second step when sonography is negative.

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