Table of Contents
International Journal of Molecular Imaging
Volume 2017 (2017), Article ID 2712018, 8 pages
Clinical Study

99mTc-Sestamibi/123I Subtraction SPECT/CT in Parathyroid Scintigraphy: Is Additional Pinhole Imaging Useful?

1Department of Nuclear Medicine, Satakunta Central Hospital, Sairaalantie 3, 28500 Pori, Finland
2Helsinki University Hospital, HUS Medical Imaging Center, P.O. Box 340, 00029 Helsinki, Finland
3Faculty of Biomedical Sciences, Tampere University of Technology, P.O. Box 692, 33101 Tampere, Finland
4Regional Imaging Center, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland
5Turku PET Centre, Turku University Hospital, P.O. Box 52, 20521 Turku, Finland
6Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, P.O. Box 52, 20521 Turku, Finland

Correspondence should be addressed to Virpi Tunninen

Received 20 July 2017; Revised 18 September 2017; Accepted 25 September 2017; Published 18 October 2017

Academic Editor: Francesca Pons

Copyright © 2017 Virpi Tunninen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. This retrospective study evaluated whether the use of additional anterior -sestamibi/123I pinhole imaging improves the outcome of -sestamibi/123I subtraction SPECT/CT in parathyroid scintigraphy (PS). Materials and Methods. PS using simultaneous dual-isotope subtraction methods and an acquisition protocol combining SPECT/CT and planar pinhole imaging was performed for 175 patients with primary or secondary hyperparathyroidism. All patients who proceeded to surgery with complete postsurgery laboratory findings were included in this study . SPECT/CT images alone and combined with pinhole images were evaluated. Results. There were 111 enlarged parathyroid glands of which 104 and 108 glands were correctly visualized by SPECT/CT (seven false positives) or SPECT/CT with pinhole (three false positives), respectively. Both sensitivity and specificity were higher with combined SPECT/CT with pinhole than with SPECT/CT alone (97% versus 94% and 99% versus 98%, resp., not significant). The false-positive rate was 6% with SPECT/CT and decreased to 3% using combined SPECT/CT with pinhole. Conclusion. -sestamibi/123I subtraction SPECT/CT is a highly sensitive and specific protocol for PS. The use of additional anterior pinhole imaging increases both sensitivity and specificity of PS, although this increase is not statistically significant.