Pinhole versus parallel-hole collimators for parathyroid imaging

An intraindividual comparison

Maria B. Tomas, Paul V. Pugliese, Gene G. Tronco, Charito Love, Christopher J. Palestro, Kenneth J. Nichols

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

This study was undertaken to determine the effects of collimators on the accuracy of preoperative sestamibi parathyroid imaging of the neck. Methods: Forty-nine patients with primary hyperparathyroidism underwent preoperative 99mTc-sestamibi parathyroid imaging. The protocol included early and late pinhole and parallel-hole imaging. One experienced nuclear physician, without knowledge of other test results or final diagnoses, interpreted studies. For both pinhole and parallel-hole images, focally increased sestamibi accumulation outside the normal tracer biodistribution that persisted or increased in intensity from early to late images was interpreted as positive for a parathyroid lesion. Final diagnoses were operatively confirmed in all patients. Results: Fifty-four parathyroid lesions were resected from the 49 patients. Forty-five patients had single-gland disease. Four patients had multigland disease: 3 had 2 lesions and 1 had 3 lesions. Median lesion weight was 840 mg. Pinhole imaging was significantly more sensitive than parallel-hole imaging (89% vs. 56%; P = 0.0003) for all 54 lesions. Specificity did not significantly differ between pinhole and parallel-hole imaging (93% vs. 96%, P = 0.29). Pinhole imaging was significantly more sensitive than parallel-hole imaging for lesions above (100% vs. 68%, P = 0.003) and below (77% vs. 42%, P = 0.03) the median weight and for single-gland disease (96% vs. 67%, P = 0.001). Pinhole imaging also was more sensitive for multigland disease, although the difference was only marginally significant (55% vs. 0%, P = 0.037). Conclusion: Because sensitivity is significantly higher, sestamibi parathyroid imaging of the neck should be performed with a pinhole collimator.

Original languageEnglish (US)
Pages (from-to)189-194
Number of pages6
JournalJournal of Nuclear Medicine Technology
Volume36
Issue number4
DOIs
StatePublished - Dec 2008
Externally publishedYes

Fingerprint

Neck
Technetium Tc 99m Sestamibi
Weights and Measures
Primary Hyperparathyroidism
Physicians

Keywords

  • Collimators
  • Image processing
  • Lesion detection
  • Primary hyperparathyroidism
  • Scintigraphy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Pinhole versus parallel-hole collimators for parathyroid imaging : An intraindividual comparison. / Tomas, Maria B.; Pugliese, Paul V.; Tronco, Gene G.; Love, Charito; Palestro, Christopher J.; Nichols, Kenneth J.

In: Journal of Nuclear Medicine Technology, Vol. 36, No. 4, 12.2008, p. 189-194.

Research output: Contribution to journalArticle

Tomas, Maria B. ; Pugliese, Paul V. ; Tronco, Gene G. ; Love, Charito ; Palestro, Christopher J. ; Nichols, Kenneth J. / Pinhole versus parallel-hole collimators for parathyroid imaging : An intraindividual comparison. In: Journal of Nuclear Medicine Technology. 2008 ; Vol. 36, No. 4. pp. 189-194.
@article{040317327cfd4a2b8877d7f29e3089d4,
title = "Pinhole versus parallel-hole collimators for parathyroid imaging: An intraindividual comparison",
abstract = "This study was undertaken to determine the effects of collimators on the accuracy of preoperative sestamibi parathyroid imaging of the neck. Methods: Forty-nine patients with primary hyperparathyroidism underwent preoperative 99mTc-sestamibi parathyroid imaging. The protocol included early and late pinhole and parallel-hole imaging. One experienced nuclear physician, without knowledge of other test results or final diagnoses, interpreted studies. For both pinhole and parallel-hole images, focally increased sestamibi accumulation outside the normal tracer biodistribution that persisted or increased in intensity from early to late images was interpreted as positive for a parathyroid lesion. Final diagnoses were operatively confirmed in all patients. Results: Fifty-four parathyroid lesions were resected from the 49 patients. Forty-five patients had single-gland disease. Four patients had multigland disease: 3 had 2 lesions and 1 had 3 lesions. Median lesion weight was 840 mg. Pinhole imaging was significantly more sensitive than parallel-hole imaging (89{\%} vs. 56{\%}; P = 0.0003) for all 54 lesions. Specificity did not significantly differ between pinhole and parallel-hole imaging (93{\%} vs. 96{\%}, P = 0.29). Pinhole imaging was significantly more sensitive than parallel-hole imaging for lesions above (100{\%} vs. 68{\%}, P = 0.003) and below (77{\%} vs. 42{\%}, P = 0.03) the median weight and for single-gland disease (96{\%} vs. 67{\%}, P = 0.001). Pinhole imaging also was more sensitive for multigland disease, although the difference was only marginally significant (55{\%} vs. 0{\%}, P = 0.037). Conclusion: Because sensitivity is significantly higher, sestamibi parathyroid imaging of the neck should be performed with a pinhole collimator.",
keywords = "Collimators, Image processing, Lesion detection, Primary hyperparathyroidism, Scintigraphy",
author = "Tomas, {Maria B.} and Pugliese, {Paul V.} and Tronco, {Gene G.} and Charito Love and Palestro, {Christopher J.} and Nichols, {Kenneth J.}",
year = "2008",
month = "12",
doi = "10.2967/jnmt.108.055640",
language = "English (US)",
volume = "36",
pages = "189--194",
journal = "Journal of Nuclear Medicine Technology",
issn = "0091-4916",
publisher = "Society of Nuclear Medicine Inc.",
number = "4",

}

TY - JOUR

T1 - Pinhole versus parallel-hole collimators for parathyroid imaging

T2 - An intraindividual comparison

AU - Tomas, Maria B.

AU - Pugliese, Paul V.

AU - Tronco, Gene G.

AU - Love, Charito

AU - Palestro, Christopher J.

AU - Nichols, Kenneth J.

PY - 2008/12

Y1 - 2008/12

N2 - This study was undertaken to determine the effects of collimators on the accuracy of preoperative sestamibi parathyroid imaging of the neck. Methods: Forty-nine patients with primary hyperparathyroidism underwent preoperative 99mTc-sestamibi parathyroid imaging. The protocol included early and late pinhole and parallel-hole imaging. One experienced nuclear physician, without knowledge of other test results or final diagnoses, interpreted studies. For both pinhole and parallel-hole images, focally increased sestamibi accumulation outside the normal tracer biodistribution that persisted or increased in intensity from early to late images was interpreted as positive for a parathyroid lesion. Final diagnoses were operatively confirmed in all patients. Results: Fifty-four parathyroid lesions were resected from the 49 patients. Forty-five patients had single-gland disease. Four patients had multigland disease: 3 had 2 lesions and 1 had 3 lesions. Median lesion weight was 840 mg. Pinhole imaging was significantly more sensitive than parallel-hole imaging (89% vs. 56%; P = 0.0003) for all 54 lesions. Specificity did not significantly differ between pinhole and parallel-hole imaging (93% vs. 96%, P = 0.29). Pinhole imaging was significantly more sensitive than parallel-hole imaging for lesions above (100% vs. 68%, P = 0.003) and below (77% vs. 42%, P = 0.03) the median weight and for single-gland disease (96% vs. 67%, P = 0.001). Pinhole imaging also was more sensitive for multigland disease, although the difference was only marginally significant (55% vs. 0%, P = 0.037). Conclusion: Because sensitivity is significantly higher, sestamibi parathyroid imaging of the neck should be performed with a pinhole collimator.

AB - This study was undertaken to determine the effects of collimators on the accuracy of preoperative sestamibi parathyroid imaging of the neck. Methods: Forty-nine patients with primary hyperparathyroidism underwent preoperative 99mTc-sestamibi parathyroid imaging. The protocol included early and late pinhole and parallel-hole imaging. One experienced nuclear physician, without knowledge of other test results or final diagnoses, interpreted studies. For both pinhole and parallel-hole images, focally increased sestamibi accumulation outside the normal tracer biodistribution that persisted or increased in intensity from early to late images was interpreted as positive for a parathyroid lesion. Final diagnoses were operatively confirmed in all patients. Results: Fifty-four parathyroid lesions were resected from the 49 patients. Forty-five patients had single-gland disease. Four patients had multigland disease: 3 had 2 lesions and 1 had 3 lesions. Median lesion weight was 840 mg. Pinhole imaging was significantly more sensitive than parallel-hole imaging (89% vs. 56%; P = 0.0003) for all 54 lesions. Specificity did not significantly differ between pinhole and parallel-hole imaging (93% vs. 96%, P = 0.29). Pinhole imaging was significantly more sensitive than parallel-hole imaging for lesions above (100% vs. 68%, P = 0.003) and below (77% vs. 42%, P = 0.03) the median weight and for single-gland disease (96% vs. 67%, P = 0.001). Pinhole imaging also was more sensitive for multigland disease, although the difference was only marginally significant (55% vs. 0%, P = 0.037). Conclusion: Because sensitivity is significantly higher, sestamibi parathyroid imaging of the neck should be performed with a pinhole collimator.

KW - Collimators

KW - Image processing

KW - Lesion detection

KW - Primary hyperparathyroidism

KW - Scintigraphy

UR - http://www.scopus.com/inward/record.url?scp=57449088422&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=57449088422&partnerID=8YFLogxK

U2 - 10.2967/jnmt.108.055640

DO - 10.2967/jnmt.108.055640

M3 - Article

VL - 36

SP - 189

EP - 194

JO - Journal of Nuclear Medicine Technology

JF - Journal of Nuclear Medicine Technology

SN - 0091-4916

IS - 4

ER -