Accuracy of early-phase versus dual-phase single-photon emission computed tomography/computed tomography in the localization of Parathyroid disease

Rajarsi Mandal, Ashok Muthukrishnan, Robert L. Ferris, John R. De Almeida, Umamaheswar Duvvuri

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives/Hypothesis Preoperative localization for parathyroid disease has improved in recent years with the advent of dual-phase 99mTc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) imaging. However, dual-phase imaging is associated with increased cost, time, and radiation dose. The aim of this study was to investigate the need for late-phase imaging when using SPECT/CT for the preoperative localization of parathyroid disease. Study Design Retrospective chart analysis. Methods A retrospective review of 75 patients who underwent preoperative imaging localization and subsequent surgical resection for parathyroid disease at a tertiary referral center was performed. Of these, 50 patients met study criteria including preoperative SPECT/CT imaging and specific reporting of early- and late-phase focal radiotracer uptake. Localization accuracy was verified with definitive surgical findings confirmed by histological analysis and evidence of biochemical cure. Results Accurate localization of adenoma(s) was seen in 78.0% of patients using dual-phase SPECT/CT. Early-phase imaging alone localized 76.0%, whereas late-phase imaging alone localized 74.0%. Sensitivity and specificity for dual-phase imaging was 84.8% and 89.6%, respectively. In comparison, early-phase localization alone was found to have a sensitivity/specificity of 84.4%/89.4%; sensitivity/specificity of late-phase scanning alone was found to be 80.4%/89.1%. Dual-phase SPECT/CT scanning did not provide a statistically significant improvement in adenoma localization when compared to early-phase scanning alone. Conclusions Although further investigation is needed, the results of this study suggest that early-phase SPECT/CT scanning alone may obviate the need for dual-phase SPECT/CT scanning in the initial preoperative localization workup of parathyroid disease.

Original languageEnglish (US)
Pages (from-to)1496-1501
Number of pages6
Issue number6
StatePublished - Jun 1 2015
Externally publishedYes


  • Parathyroid
  • minimally invasive parathyroidectomy
  • parathyroid preoperative localization
  • parathyroid single-photon emission computed tomography/computed tomography

ASJC Scopus subject areas

  • Otorhinolaryngology


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