UOC di Medicina Nucleare, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.
Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168, Rome, Italy.
J Endocrinol Invest. 2019 Aug;42(8):889-895. doi: 10.1007/s40618-018-0996-8. Epub 2019 Jan 1.
Parathyroid scintigraphy is superior to other imaging techniques in detecting hyperfunctioning parathyroid glands. It is mainly performed using double-phase or dual-tracer subtraction methods. Neither of the techniques is perfect and different protocols are being used. We aimed to evaluate the accuracy of double-phase and subtraction methods in detecting abnormal gland as well as the potential effects of coexisting thyroid disease and clinical-laboratory data.
We considered patients with primary hyperparathyroidism who underwent parathyroid surgery, after a parathyroid scintigraphy between April 2015 and February 2017. Sixty-eight patients were included; in 45 cases (66.2%), a thyroid disease was coexistent. Diagnostic performances of the two techniques were compared. The effect of thyroid disease and clinical-pathological data on examination interpretation was considered.
Double-phase scintigraphy showed higher sensitivity and accuracy in detecting the exact abnormal gland compared to the digital subtraction (90% and 75% vs. 76% and 66%, respectively). For double-phase technique, sensitivity and accuracy were higher in cases with no thyroid disease when compared to those with thyroid disease (92% and 86% vs. 88% and 69%, respectively). Similarly, for digital subtraction, sensitivity and accuracy were higher in the absence of thyroid disease compared to their presence (84% and 79% vs. 70% and 58%, respectively). There was no significant variation in the performance of both techniques, considering clinical-laboratory data.
Double-phase scintigraphy has been more accurate than digital subtraction. The presence of thyroid disease could be a possible limit, affecting the subtraction more than the double-phase technique. Clinical data did not influence the scintigraphic outcome.
甲状旁腺闪烁显像在检测功能亢进的甲状旁腺方面优于其他成像技术。它主要使用双时相或双示踪剂减影法进行。这两种技术都不是完美的，不同的方案正在使用。我们旨在评估双时相和减影方法在检测异常腺体中的准确性，以及共存甲状腺疾病和临床-实验室数据的潜在影响。
我们考虑了 2015 年 4 月至 2017 年 2 月期间接受甲状旁腺手术的原发性甲状旁腺功能亢进患者的甲状旁腺闪烁显像。共纳入 68 例患者；其中 45 例（66.2%）合并甲状腺疾病。比较了两种技术的诊断性能。考虑了甲状腺疾病和临床病理数据对检查解释的影响。
双时相闪烁显像在检测确切异常腺体方面的敏感性和准确性均高于数字减影（90%和 75%与 76%和 66%）。对于双时相技术，在无甲状腺疾病的情况下，敏感性和准确性高于有甲状腺疾病的情况（92%和 86%与 88%和 69%）。同样，对于数字减影，在无甲状腺疾病的情况下，敏感性和准确性高于有甲状腺疾病的情况（84%和 79%与 70%和 58%）。考虑到临床实验室数据，两种技术的性能均无显著差异。
双时相闪烁显像比数字减影更准确。甲状腺疾病的存在可能是一个潜在的限制，对减影的影响大于双时相技术。临床数据对闪烁显像结果没有影响。
