Comparison of different strategies in parathyroid scintigraphy imaging [abstract]
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To retrospectively compare the various scintigraphic methods to discover the most accurate protocol for preoperative localization of single-gland disease, medical records of 710 patients, diagnosed with primary were reviewed. 293 patients had complete preoperative parathyroid scintigraphy with subsequent surgical resection of a single abnormal gland. Parathyroid scintigraphy at our institution utilizes 99mTc sestamibi (MIBI) and 123I, and consists of early and delayed pinhole MIBI images of the neck, including MIBI-123I subtraction imaging, as well as MIBI single photon emission computed tomography (SPECT) of the neck and chest. Four experienced nuclear medicine physicians, without knowledge of clinical or laboratory results or final diagnosis, reviewed seven different imaging variations in separate sessions. The imaging variations were early MIBI only (EARLY), delayed MIBI only (DELAYED), comparison of early and delayed MIBI (E-D), subtraction (SUB), all planar (PLANAR), SPECT only (SPECT), and all images (ALL).