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Intraoperative 3-D mapping of parathyroid adenoma using freehand SPECT.

Rahbar K, Colombo-Benkmann M, Haane C, Wenning C, Vrachimis A, Weckesser M, Schober O - EJNMMI Res (2012)

Bottom Line: Freehand single photon emission computed tomography (fSPECT) is a three-dimensional (3-D) tomographic imaging modality based on data acquisition with a handheld detector that is moved freely, in contrast to conventional, gantry-mounted gamma camera systems.Two patients were referred with persistent hyperparathyroidism after conventional parathyroidectomy.Parathyroid hormone level decreased intraoperatively in all three patients, on average, by 79% (range 72% to 91%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, Muenster, 48149, Germany. rahbar@uni-muenster.de.

ABSTRACT

Background: Freehand single photon emission computed tomography (fSPECT) is a three-dimensional (3-D) tomographic imaging modality based on data acquisition with a handheld detector that is moved freely, in contrast to conventional, gantry-mounted gamma camera systems. In this pilot study, we evaluated the feasibility of fSPECT for intraoperative 3-D mapping in patients with parathyroid adenomas.

Methods: Three patients (range 30 to 45 years) diagnosed with hyperparathyroidism (one primary and two tertiary) underwent parathyroid scintigraphy with technetium-99m sestamibi (99mTc-MIBI) to localize parathyroid adenomas. Two patients were referred with persistent hyperparathyroidism after conventional parathyroidectomy. In all three patients, a planar scintigraphy of the neck was performed 10 min after injection (p.i.) followed by SPECT/CT (Symbia T2, Siemens Healthcare) and a correlative ultrasound 2 h p.i. 99mTc-MIBI scan was performed the day before surgery in two patients and at the same day in one patient. fSPECT images were acquired intraoperatively using declipse SPECT (SurgicEyeTM).

Results: A total of five parathyroid adenomas were successfully located with SPECT/CT. fSPECT allowed intraoperative detection of all adenomas, and successful parathyroidectomy was accomplished. Parathyroid hormone level decreased intraoperatively in all three patients, on average, by 79% (range 72% to 91%).

Conclusion: In this preliminary study, we could demonstrate that intraoperative localization of parathyroid adenomas is feasible using the freehand SPECT technology, thus allowing an image-guided parathyroidectomy.

No MeSH data available.


Related in: MedlinePlus

Coronal slices of fused 3-D-reconstructed SPECT/CT images of all three patients. Yellow arrows show the parathyroid adenomas in each image.
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Figure 4: Coronal slices of fused 3-D-reconstructed SPECT/CT images of all three patients. Yellow arrows show the parathyroid adenomas in each image.

Mentions: A new device like fSPECT causes not only costs in purchasing the device itself, but also daily costs for the fiducials. Hybrid imaging using SPECT/CT to localize parathyroid adenomas has high accuracy [6], and fused 3-D-reconstructed images can help surgeons in a similar way (Figure 4).


Intraoperative 3-D mapping of parathyroid adenoma using freehand SPECT.

Rahbar K, Colombo-Benkmann M, Haane C, Wenning C, Vrachimis A, Weckesser M, Schober O - EJNMMI Res (2012)

Coronal slices of fused 3-D-reconstructed SPECT/CT images of all three patients. Yellow arrows show the parathyroid adenomas in each image.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472282&req=5

Figure 4: Coronal slices of fused 3-D-reconstructed SPECT/CT images of all three patients. Yellow arrows show the parathyroid adenomas in each image.
Mentions: A new device like fSPECT causes not only costs in purchasing the device itself, but also daily costs for the fiducials. Hybrid imaging using SPECT/CT to localize parathyroid adenomas has high accuracy [6], and fused 3-D-reconstructed images can help surgeons in a similar way (Figure 4).

Bottom Line: Freehand single photon emission computed tomography (fSPECT) is a three-dimensional (3-D) tomographic imaging modality based on data acquisition with a handheld detector that is moved freely, in contrast to conventional, gantry-mounted gamma camera systems.Two patients were referred with persistent hyperparathyroidism after conventional parathyroidectomy.Parathyroid hormone level decreased intraoperatively in all three patients, on average, by 79% (range 72% to 91%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, Gebäude A1, Muenster, 48149, Germany. rahbar@uni-muenster.de.

ABSTRACT

Background: Freehand single photon emission computed tomography (fSPECT) is a three-dimensional (3-D) tomographic imaging modality based on data acquisition with a handheld detector that is moved freely, in contrast to conventional, gantry-mounted gamma camera systems. In this pilot study, we evaluated the feasibility of fSPECT for intraoperative 3-D mapping in patients with parathyroid adenomas.

Methods: Three patients (range 30 to 45 years) diagnosed with hyperparathyroidism (one primary and two tertiary) underwent parathyroid scintigraphy with technetium-99m sestamibi (99mTc-MIBI) to localize parathyroid adenomas. Two patients were referred with persistent hyperparathyroidism after conventional parathyroidectomy. In all three patients, a planar scintigraphy of the neck was performed 10 min after injection (p.i.) followed by SPECT/CT (Symbia T2, Siemens Healthcare) and a correlative ultrasound 2 h p.i. 99mTc-MIBI scan was performed the day before surgery in two patients and at the same day in one patient. fSPECT images were acquired intraoperatively using declipse SPECT (SurgicEyeTM).

Results: A total of five parathyroid adenomas were successfully located with SPECT/CT. fSPECT allowed intraoperative detection of all adenomas, and successful parathyroidectomy was accomplished. Parathyroid hormone level decreased intraoperatively in all three patients, on average, by 79% (range 72% to 91%).

Conclusion: In this preliminary study, we could demonstrate that intraoperative localization of parathyroid adenomas is feasible using the freehand SPECT technology, thus allowing an image-guided parathyroidectomy.

No MeSH data available.


Related in: MedlinePlus