ArticleClinical physiology and functional imaging2026
Dual-isotope subtraction scintigraphy and SPECT-CT for preoperative localization of parathyroid adenomas.
Article in Clinical physiology and functional imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
contextPrimary hyperparathyroidism (PHPT) is often caused by a parathyroid adenoma (PTA). Subtraction scintigraphy with
objectiveThis study evaluated patients referred for HS, the ability of the HS to correctly localize PTA(s), as well as the diagnostic performance of HS.
methodsData was retrospectively analyzed for 300 patients with PHPT referred for HS from 2019 to 2023 in a single-centre hospital. We used Begg and Greenes' correction method to calculate diagnostic accuracy, as well as calculated percentage of adenoma(s) correctly localized per patient who underwent PTX or bilateral neck exploration (BNE).
resultsIn 282 patients with PHPT undergoing HS for PTA localization, the HS was positive in 71%. Only 65% of these patients were referred to PTX. Using correction methods, we found a sensitivity and specificity of the HS of 73% and 78%, respectively. The positive predictive value was 99%, while the negative predictive value was 9%. The HS correctly localized PTA in 90% of the patients. Scintigraphy correctly localized 86% of the PTAs, SPECT-CT 85%, and ultrasound 76%.
conclusionA positive HS was very likely to localize the PTA correctly, whereas a negative HS had limited diagnostic value. Surprisingly, a large proportion of patients undergoing HS were never considered for surgery, resulting in partial reference bias in the evaluation of the diagnostic accuracy.
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