Champendal Mélanie, Jreige Mario, Nicod Lalonde Marie, Pires Jorge José A, Matter Maurice, Sykiotis Gerasimos P, Prior John O
School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, 1011 Lausanne, Switzerland.
Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland.
Diagnostics (Basel). 2023 Jun 28;13(13):2200. doi: 10.3390/diagnostics13132200.
The aim of this prospective pilot study was to evaluate the feasibility of a new hybrid imaging modality, free-hand single-photon computed tomography/ultrasonography (fhSPECT/US), for preoperative localization of parathyroid adenomas and to compare its performance with conventional ultrasonography and SPECT/CT. Twelve patients diagnosed with primary hyperparathyroidism underwent sequentially US and parathyroid scintigraphy, including SPECT/CT, followed by fhSPECT/US, allowing for real-time fusion between US and freehand-generated gamma-camera images. The fhSPECT/US detection rates were correlated with histopathology, when available, or with the imaging modality showing the most lesions. Based on a per patient analysis, the detection rate was significantly different when comparing SPECT/CT to fhSPECT/US ( = 0.03), and not significantly different when comparing SPECT/CT to US ( = 0.16) and US to fhSPECT/US ( = 0.08). Based on a per-lesion analysis, the detection rate of SPECT/CT was significantly higher than that of US ( = 0.01) and fhSEPCT/US ( = 0.003), and there was no significant difference in detection rate when comparing US to fhSPECT/US ( = 0.08). The main perceived limitations of fhSPECT/US in lesion detection were: (i) lesions localized at a depth ≥4.5 cm; (ii) imperfect image fusion due to tissue compression; (iii) limited spatial manipulation ability of the SPECT mobile camera handheld probe; and (iv) a wide spread of detected activity. In conclusion, clinical use of fhSPECT/US for localization of parathyroid adenomas is feasible, but shows lower sensitivity than conventional modalities and requires technical improvements.
这项前瞻性试点研究的目的是评估一种新的混合成像模式——徒手单光子计算机断层扫描/超声检查（fhSPECT/US）用于甲状旁腺腺瘤术前定位的可行性，并将其性能与传统超声检查和SPECT/CT进行比较。12例诊断为原发性甲状旁腺功能亢进症的患者依次接受了超声检查和甲状旁腺闪烁扫描，包括SPECT/CT，随后进行fhSPECT/US检查，实现了超声图像与徒手生成的伽马相机图像之间的实时融合。当有组织病理学结果时，fhSPECT/US的检测率与组织病理学相关，或者与显示最多病变的成像模式相关。基于每位患者的分析，比较SPECT/CT与fhSPECT/US时检测率有显著差异（=0.03），比较SPECT/CT与超声检查时检测率无显著差异（=0.16），比较超声检查与fhSPECT/US时检测率无显著差异（=0.08）。基于每个病灶的分析，SPECT/CT的检测率显著高于超声检查（=0.01）和fhSEPCT/US（=0.003），比较超声检查与fhSPECT/US时检测率无显著差异（=0.08）。fhSPECT/US在病灶检测中主要的可感知局限性为：（i）病灶位于深度≥4.5厘米处；（ii）由于组织压缩导致图像融合不完美；（iii）SPECT移动相机手持探头的空间操作能力有限；（iv）检测到的放射性分布广泛。总之，fhSPECT/US用于甲状旁腺腺瘤定位的临床应用是可行的，但灵敏度低于传统模式，需要技术改进。
