Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario

Background: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. Aim: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Paillahueque,Gabriela, Massardo,Teresa, Barberán,Marcela, Ocares,Gerson, Gallegos,Iván, Toro,Luis, Araya,A. Verónica
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2017
Materias:
Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000801021
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:scielo:S0034-98872017000801021
record_format dspace
spelling oai:scielo:S0034-988720170008010212017-11-27Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitarioPaillahueque,GabrielaMassardo,TeresaBarberán,MarcelaOcares,GersonGallegos,IvánToro,LuisAraya,A. Verónica Hyperparathyroidism Primary Parathyroid Neoplasms Parathyroidectomy Technetium Tc 99m Sestamibi Background: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. Aim: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. Material and Methods: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. Results: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. Conclusions: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.8 20172017-08-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000801021es10.4067/s0034-98872017000801021
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Hyperparathyroidism
Primary
Parathyroid Neoplasms
Parathyroidectomy
Technetium Tc 99m Sestamibi
spellingShingle Hyperparathyroidism
Primary
Parathyroid Neoplasms
Parathyroidectomy
Technetium Tc 99m Sestamibi
Paillahueque,Gabriela
Massardo,Teresa
Barberán,Marcela
Ocares,Gerson
Gallegos,Iván
Toro,Luis
Araya,A. Verónica
Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
description Background: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. Aim: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. Material and Methods: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. Results: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. Conclusions: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.
author Paillahueque,Gabriela
Massardo,Teresa
Barberán,Marcela
Ocares,Gerson
Gallegos,Iván
Toro,Luis
Araya,A. Verónica
author_facet Paillahueque,Gabriela
Massardo,Teresa
Barberán,Marcela
Ocares,Gerson
Gallegos,Iván
Toro,Luis
Araya,A. Verónica
author_sort Paillahueque,Gabriela
title Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
title_short Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
title_full Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
title_fullStr Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
title_full_unstemmed Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
title_sort análisis de falsos negativos en la cintigrafía spect de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario
publisher Sociedad Médica de Santiago
publishDate 2017
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000801021
work_keys_str_mv AT paillahuequegabriela analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
AT massardoteresa analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
AT barberanmarcela analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
AT ocaresgerson analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
AT gallegosivan analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
AT toroluis analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
AT arayaaveronica analisisdefalsosnegativosenlacintigrafiaspectdeparatiroidesconsestamibienpacientesconhiperparatiroidismoprimariosometidosacirugiaentre20082015enhospitaluniversitario
_version_ 1718436960082591744