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Diagnostic performance of planar scintigraphy using (99m)Tc-MIBI in patients with secondary hyperparathyroidism: a meta-analysis.
MedLine Citation:
PMID:  22875577     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Parathyroid scintigraphy using (99m)Tc-MIBI is not currently considered a valuable diagnostic tool for the localization of involved glands in patients with secondary hyperparathyroidism (SHPT). However, published data about its diagnostic accuracy are discordant and a meta-analysis about this topic is still lacking. The aim of our study is to meta-analyze the published data about the diagnostic performance of (99m)Tc-MIBI parathyroid scintigraphy in patients with SHPT. METHODS: A comprehensive computer literature search of studies published in PubMed/MEDLINE, Scopus and Embase databases through September 2011 and regarding the diagnostic accuracy of (99m)Tc-MIBI parathyroid scintigraphy in patients with SHPT was carried out. Only articles in English language in which at least 10 patients with SHPT underwent planar (99m)Tc-MIBI parathyroid scintigraphy were selected. Pooled sensitivity, pooled specificity and area under the ROC curve on a per lesion-based analysis were calculated to measure the diagnostic accuracy of (99m)Tc-MIBI parathyroid scintigraphy in SHPT patients. RESULTS: Twenty-four studies comprising 471 patients were included in this meta-analysis. The pooled sensitivity and specificity of (99m)Tc-MIBI parathyroid scintigraphy in detecting hyperplastic glands in SHPT patients were 58 % [95 % confidence interval (95 % CI) 52-65 %] and 93 % (95 % CI 85-100 %), respectively, on a per lesion-based analysis. Area under ROC curve was 0.75. CONCLUSIONS: In patients with SHPT and diffuse or nodular hyperplasia, planar parathyroid scintigraphy using (99m)Tc-MIBI has demonstrated an inadequate diagnostic accuracy. Therefore, it should not be considered as a first-line diagnostic imaging method in the pre-surgical detection of hyperplastic parathyroid glands.
Authors:
Carmelo Caldarella; Giorgio Treglia; Alfredo Pontecorvi; Alessandro Giordano
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-9
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  -     ISSN:  1864-6433     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Bioimaging and Radiological Sciences, Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, 00168, Rome, Italy, carmelocaldarella@yahoo.it.
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