Increased sensitivity and confidence of SPECT over planar imaging in dual-phase sestamibi for parathyroid adenoma detection

Purpose of Report: To determine the usefulness of SPELT imaging over planar imaging for the detection of parathyroid adenomas using dual-phase Tc-99m sestamibi. Materials and Methods: The records of patients referred for dual-phase sestamibi scintigraphy for detection of parathyroid adenomas were reviewed retrospectively. The images were reviewed blindly and planar images were compared with SPELT. The imaging results were compared with the operative results to determine the sensitivity, accuracy of localization, and confidence of the reporting radiologist. Results: The records of 37 patients were reviewed. Sensitivity was 62% for planar imaging and 73% for SPELT. There was one false positive. The side of the adenoma was correctly identified in all other patients. Confidence of detection was higher for SPELT than for planar imaging. Conclusion: SPELT imaging increased the sensitivity and confidence of the detection of parathyroid adenomas. The results indicate that SPELT should be used for all preoperative parathyroid localization.