CT-MIBI image fusion: a new preoperative localization technique for primary, recurrent, and persistent XXXX .

@entity1 @entity1136 @entity2742
BACKGROUND: Successful minimally invasive or imaging-guided operations in @entity1 with primary, recurrent, and persistent @entity2742 are based on the reliability of preoperative parathyroid localization studies. The CT-MIBI image fusion promises a higher diagnostic accuracy than current imaging procedures. The aim of our study was to assess its reliability in correctly detecting enlarged parathyroid glands. METHODS: In a prospective study 24 consecutive @entity1 underwent CT-MIBI image fusion as preoperative parathyroid localization procedure. The results of @entity1136 99m sestamibi single photon emission computed tomography (MIBI-SPECT) alone, today the standard method in parathyroid imaging, and CT-MIBI image fusion were analyzed by a blinded reviewer, and the imaging results were compared with the intraoperative findings. RESULTS: For CT-MIBI image fusion a sensitivity of 93% and a specificity of 100% in correctly detecting the position of enlarged parathyroid glands was calculated and compared with a sensitivity of MIBI-SPECT of 31% and a specificity of 87% (P<.001). This new imaging technique enabled us to successfully treat 22 of our @entity1 (92%) with imaging-guided surgery. Twenty (83%) underwent unilateral or minimally invasive operations. CONCLUSIONS: CT-MIBI image fusion appears to be superior to MIBI-SPECT in preoperative parathyroid imaging. CT-MIBI image fusion can be performed on existing CT- and MIBI-SPECT units. We recommend this method for preoperative localization in @entity1 with primary, recurrent and persistent @entity2742 .
