nuclear-medicine-radiation-therapy-2018-posters

Page 50

Journal of Medical Physics and Applied Sciences

ISSN: 2574-285X

I n t e r n a t i o n a l C o n f e r e n c e o n

Nuclear Medicine &

Radiation Therapy

Nuclear Medicine & Radiation Therapy 2018

O c t o b e r 0 1 - 0 2 , 2 0 1 8

S t o c k h o l m , S w e d e n

Background:

Pre-operative localization of hyperfunctioning parathyroid lesions with dual phase

99m

Tc-Sestamibi imaging is a

reliable and accurate method, with variable, but high reported sensitivity and specificity for single adenomas. The most common

cause of a false positive finding is co-existent nodular thyroid disease. Other causes of false positive findings include the

presence of thyroid carcinoma, parathyroid carcinoma, lymphadenopathy, sarcoidosis and other tumours. In order to plan the

optimal surgical approach and minimize patient morbidity, it is of vital importance to minimize false positive reports.

Aim:

To demonstrate the importance of combined

99m

Tc-sestamibi and

99m

Tc-pertechnetate thyroid imaging in the pre-operative

localization of suspected parathyroid lesions.

Methodology:

We present a female patient, aged 38 years, with primary hyperparathyroidism. She was referred to the nuclear

medicine department for pre-operative localization of parathyroid adenoma with

99m

Tc-sestamibi scan.

Results:

On the early images of the dual phase

99m

Tc-Sestamibi scan focal tracer accumulation was seen in the superior pole of

the left thyroid lobe, which increased in intensity on the delayed images. Single photon emission computed tomography (SPECT)

reconstructed images confirmed the location within the left thyroid lobe. Subsequent

99m

Tc-pertechnetate thyroid images

demonstrated a hot nodule in the superior pole of the left thyroid lobe; in the same location as seen on the

99m

Tc-sestamibi

scan. The patient was referred for a thyroid ultrasound, which confirmed a benign spongiform nodule in the same location. No

suspicious parathyroid lesions were seen on ultrasound. Thyroid function tests revealed subclinical hyperthyroidism.

Conclusion:

Coexisting solid thyroid nodules may contribute to false positive localization of parathyroid lesion. Furthermore, the

intensity of uptake in these thyroid nodules can potentially result in failure to visualize and locate the suspected hyperfunctioning

parathyroid lesion. Dual tracer imaging with

99m

Tc-sestamibi and 99mTc-pertechnetate should always be considered in cases

with apparent intrathyroidal tracer accumulation on

99m

Tc-sestamibi scan to increase the specificity by minimizing false positive

findings. The highest sensitivity and specificity for accurate parathyroid lesion localization will be achieved by the combination of

dual tracer subtraction and thyroid ultrasound. These instructions give you guidelines for preparing papers.

nmuambadzi@yahoo.com

Thyroid nodules the dark horse of parathyroid

imaging

Ntanganedzeni Muambadzi, L Louw and MDTHW Vangu

Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand

J. med phys & appl sci 2018, Volume: 3

DOI: 10.21767/2574-285X-C1-003