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Title: Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery

Abstract

Parathyroid imaging based on the principle of differential uptakes of Tc-99m and T1-201 in the anterior neck to localize parathyroid (PT) disease has been reported with widely varying results. To evaluate the usefulness of this method, we have performed PT imaging on 47 patients prior to exploratory surgery for PT disease. Using pinhole collimation and digital acquisition, a 50k count image of the thyroid was obtained 20 minutes after injection of 1mCi99m Tc-pertechnetate. Then a lmCi dose of Tl-201 chloride was injected and a series of images acquired for 30 minutes at 30 sec/image. Raw data was spatially filtered and normalized by summing sufficient T1-201 images to equal the Tc-99m image scale of maximum cts/pixel. Image subtraction (Tl-Tc) gave the final PT image. Of 10 pts who had previous neck exploration, all had PT pathology accurately localized by preoperative scanning (7=single adenoma, 2=single hyperplastic gland, 1=two hyperplastic glands). In two causes distant ectopic pathology was localized in the strap muscles of the neck. For the 37 pts without previous surgery, scanning localized 85% of adenomas and 44% of hyperplastic glands with a false positive rate of 17%. Patient motion and coexisting thyroid disease particularly degraded final image quality. The authorsmore » conclude that preoperative PT imaging is a valuable aid for localizing pathology in patients who undergo secondary neck exploration but has only limited use for screening primary surgical cases.« less

Authors:
; ; ;
Publication Date:
Research Org.:
Cleveland Clinic Foundation, Cleveland, OH
OSTI Identifier:
6856096
Report Number(s):
CONF-850611-
Journal ID: CODEN: JNMEA; TRN: 87-010659
Resource Type:
Conference
Journal Name:
J. Nucl. Med.; (United States)
Additional Journal Information:
Journal Volume: 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADENOMAS; DIAGNOSIS; PARATHYROID GLANDS; RADIONUCLIDE KINETICS; SCINTISCANNING; TECHNETIUM 99; TISSUE DISTRIBUTION; UPTAKE; THALLIUM 201; THYROID; BIOLOGICAL LOCALIZATION; DUAL-ISOTOPE SUBTRACTION TECHNIQUE; IMAGES; NECK; PATHOLOGY; PATIENTS; RADIOPHARMACEUTICALS; SURGERY; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; BODY AREAS; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; DISTRIBUTION; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; ENDOCRINE GLANDS; GLANDS; HEAVY NUCLEI; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPE APPLICATIONS; ISOTOPES; LABELLED COMPOUNDS; MEDICINE; NEOPLASMS; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; TECHNETIUM ISOTOPES; THALLIUM ISOTOPES; TRACER TECHNIQUES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

O'Donnell, J K, Broughan, T A, Kropilak, M D, and Esselstyn, Jr, C B. Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery. United States: N. p., 1985. Web.
O'Donnell, J K, Broughan, T A, Kropilak, M D, & Esselstyn, Jr, C B. Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery. United States.
O'Donnell, J K, Broughan, T A, Kropilak, M D, and Esselstyn, Jr, C B. 1985. "Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery". United States.
@article{osti_6856096,
title = {Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery},
author = {O'Donnell, J K and Broughan, T A and Kropilak, M D and Esselstyn, Jr, C B},
abstractNote = {Parathyroid imaging based on the principle of differential uptakes of Tc-99m and T1-201 in the anterior neck to localize parathyroid (PT) disease has been reported with widely varying results. To evaluate the usefulness of this method, we have performed PT imaging on 47 patients prior to exploratory surgery for PT disease. Using pinhole collimation and digital acquisition, a 50k count image of the thyroid was obtained 20 minutes after injection of 1mCi99m Tc-pertechnetate. Then a lmCi dose of Tl-201 chloride was injected and a series of images acquired for 30 minutes at 30 sec/image. Raw data was spatially filtered and normalized by summing sufficient T1-201 images to equal the Tc-99m image scale of maximum cts/pixel. Image subtraction (Tl-Tc) gave the final PT image. Of 10 pts who had previous neck exploration, all had PT pathology accurately localized by preoperative scanning (7=single adenoma, 2=single hyperplastic gland, 1=two hyperplastic glands). In two causes distant ectopic pathology was localized in the strap muscles of the neck. For the 37 pts without previous surgery, scanning localized 85% of adenomas and 44% of hyperplastic glands with a false positive rate of 17%. Patient motion and coexisting thyroid disease particularly degraded final image quality. The authors conclude that preoperative PT imaging is a valuable aid for localizing pathology in patients who undergo secondary neck exploration but has only limited use for screening primary surgical cases.},
doi = {},
url = {https://www.osti.gov/biblio/6856096}, journal = {J. Nucl. Med.; (United States)},
number = ,
volume = 26:5,
place = {United States},
year = {Wed May 01 00:00:00 EDT 1985},
month = {Wed May 01 00:00:00 EDT 1985}
}

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