Feasibility and Performance of Free-Hand Single-Photon Computed Tomography/Ultrasonography for Preoperative Parathyroid Adenoma Localization: A Pilot Study-Reference-Cited by-同舟云学术

Feasibility and Performance of Free-Hand Single-Photon Computed Tomography/Ultrasonography for Preoperative Parathyroid Adenoma Localization: A Pilot Study

Published:2023-06-28 Issue:13 Volume:13 Page:2200
ISSN:2075-4418
Container-title:Diagnostics
language:en
Short-container-title:Diagnostics

Author:

Champendal Mélanie¹^ORCID,Jreige Mario²,Nicod Lalonde Marie²^ORCID,Pires Jorge José A.¹,Matter Maurice³^ORCID,Sykiotis Gerasimos P.⁴^ORCID,Prior John O.²^ORCID

Affiliation:

1. School of Health Sciences HESAV, HES-SO, University of Applied Sciences Western Switzerland, 1011 Lausanne, Switzerland

2. Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland

3. Visceral Surgery Department, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland

4. Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland

Abstract

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 (p = 0.03), and not significantly different when comparing SPECT/CT to US (p = 0.16) and US to fhSPECT/US (p = 0.08). Based on a per-lesion analysis, the detection rate of SPECT/CT was significantly higher than that of US (p = 0.01) and fhSEPCT/US (p = 0.003), and there was no significant difference in detection rate when comparing US to fhSPECT/US (p = 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.

Publisher

MDPI AG

Subject

Clinical Biochemistry

Link

https://www.mdpi.com/2075-4418/13/13/2200/pdf

Reference32 articles.

1. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003;Ruda;Otolaryngol. Head Neck Surg.,2005

2. Age and gender distribution of primary hyperparathyroidism and incidence of surgical treatment in a European country with a particularly high life expectancy;Richert;Swiss Med. Wkly.,2009

3. 2009 EANM parathyroid guidelines;Ugur;Eur. J. Nucl. Med. Mol. Imaging,2009

4. Hyperparathyroïdie primaire: Échographie et scintigraphie;Richard;J. Radiol.,2009

5. The definitive management of primary hyperparathyroidism who needs an operation?;Campbell;JAMA J. Am. Med. Assoc.,2017