Hybrid imaging using low-dose, localizing computed tomography enhances lesion localization in renal hyperparathyroidism

Doruyter, Alexander G. ; Hartley, Tharbit ; Ameyo, Jonathan W. ; Davids, M. R. ; Warwick, James M. (2014-03)

Doruyter, A.G. et al. 2014. Hybrid imaging using low-dose, localizing computed tomography enhances lesion localization in renal hyperparathyroidism. Nuclear Medicine Communications, 35(8):884-889, doi:10.1097/MNM.0000000000000131.

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Article

Background Preoperative localization of parathyroid lesions is potentially beneficial in renal patients with hyperparathyroidism. The aim of this study was to determine the localizing value of hybrid single-photon emission computed tomography combined with low-dose x-ray computed tomography (SPECT/LDCT) compared with SPECT alone and whether the LDCT improved reader confidence. Patients and methods A retrospective study examined parathyroid scintigraphy results of patients previously referred with a diagnosis of renal hyperparathyroidism. All patients underwent planar scintigraphy using technetium- 99m (99mTc)-pertechnetate, which was immediately followed with 99mTc-sestamibi and SPECT/LDCT ∼ 60 min after sestamibi injection and a delayed static image to assess differential washout. Planar subtraction images were generated. Two nuclear physicians, assisted by a radiologist, reported on planar+SPECT images followed by planar+SPECT/LDCT images. Results Thirty-seven patients (males: 21; females: 16) were included (mean age 39 years, range: 23.9–55.5). Mean creatinine level was 878 μmol/l (109–1839), mean corrected calcium level was 2.42 mmol/l (1.77–3.64), and median parathyroid hormone level was 156.2 pmol/l (2.4 to >201). Twenty-three patients had positive planar and SPECT

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