Value of the Combination Ultrasonography With Ti-RADS Score / Dual Tracer Scintigraphy MIBI-Tc99m/Iodine-123 in the Detection of Malignancy of Thyroid Nodules (Sup or Egal to 15 mm) Classified Bethesda III or IV on Cytology

The main objective of the study is to show that the addition of ultrasonography to the dual tracer scintigraphy MIBI-Tc99m/Iodine-123 will increase (at least +5%) the negative predictive value compared to the dual tracer scintigraphy alone in detection of malignancy in thyroid nodules ≥15 mm classified as Bethesda III-IV on cytology.

开始日期2019-01-17

申办/合作机构

Nantes University Hospital

100 项与 MIBI-Tc99m/Iodine-123 相关的临床结果

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100 项与 MIBI-Tc99m/Iodine-123 相关的转化医学

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100 项与 MIBI-Tc99m/Iodine-123 相关的专利（医药）

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项与 MIBI-Tc99m/Iodine-123 相关的文献（医药）

2022-02-01·The American Surgeon™4区 · 医学

Routine Use of Preoperative Neck Ultrasound in Primary Hyperparathyroidism Identifies Coexisting Thyroid Disease and Improves Parathyroid Localization

4区 · 医学

Article

作者: Mckenzie, Travis ; Rocco, Raffaele ; Dy, Benzon ; Thompson, Geoffrey ; Foster, Trenton ; Wermers, Robert ; Lyden, Melanie

Background In Jan 2018, we began routinely obtaining neck ultrasound (US) with 123I/99Tc-sestamibi (MIBI) for parathyroid gland localization and to identify thyroid pathology in the setting of primary hyperparathyroidism (1HPT). The aim of this study is to assess if routine neck US is a useful adjunct to 123I/99Tc-MIBI in 1HPT. Methods Patients undergoing surgery for 1HPT with both 123I/99Tc-MIBI and US at our institution after implementation of routine US were reviewed. Biopsy and surgical management of thyroid pathology was evaluated. 123I/99Tc-MIBI and US results were compared to intraoperative findings to determine sensitivity and positive predictive value (PPV) for parathyroid localization. Results From January 2018 to September 2019, there were 423 patients (mean, 61 years) that met inclusion criteria (80% women). Thyroid nodules were found on US in 57%, mean size 1.3 + 0.8 cm. Fine needle aspiration (FNA) was performed in 87 patients with nodules (36%). 35 patients (8.5%) required total or partial thyroidectomy for diagnoses/treatment. Papillary thyroid cancer (PTC) was found in 3.5% of the cohort with micro-PTC 53% and PTC 1-2 cm 40%. A successful parathyroid operation for 1HPT was achieved in 98.6% of patients. Positive predictive value for localization of abnormal parathyroid glands was 97% when US and 123I/99Tc-MIBI had concordant findings. Discussion Routine use of US in 1HPT commonly identifies nodules that are benign or low-risk PTC. Ultrasound is less sensitive for parathyroid localization but when used with 123I/99Tc-MIBI, concordant imaging has a high PPV.

2003-08-01·The American Surgeon4区 · 医学

Optimization of the Gamma Probe-Guided Parathyroidectomy

4区 · 医学

Article

作者: Ugur, Omer ; Hamaloglu, Erhan ; Sayek, Iskender ; Gulec, Seza A. ; Bozkurt, M. Fani

The objective of this study was to determine the patient-specific optimal time to surgery preoperatively to improve operative success in gamma probe-guided parathyroid localization. Fifteen patients with hyperparathyroidism underwent a double-phase Tc99m-MIBI (15–20 mCi) parathyroid scintigraphy to study the Tc99m-MIBI clearance kinetics from parathyroid and thyroid glands and to determine the time point at which the optimal target-to-background ratio was achieved. Optimal time to surgery was determined on the basis of the time at which the target-to-background ratio was maximal. On the day of surgery the patients received the same dose of Tc99m-MIBI and were taken to the operating room at the time of optimal target-to-background ratio. A four-gland exploration was performed with identification and excision of hot lesions using a gamma probe. Ex vivo lesion-to-background ratios were determined. Histopathologic confirmation of a successful parathyroidectomy was obtained intraoperatively by frozen section. The total operative time and the time to localize and excise the parathyroid glands were recorded. The mean surgery time was compared with that of previous parathyroidectomies performed by the same surgical team without use of preoperative scintigraphy and intraoperative gamma probe. Scintigraphy correctly localized parathyroid pathology in 12 of 15 (80%) patients. Intraoperative gamma probe was successful in 15 of 15 (100%). The optimal time to surgery was found to be different for each patient, and the mean time was calculated as 136 ± 43 minutes. Mean surgery time for the excision of parathyroid gland was 91 ± 46 minutes, which was significantly shorter than previous four-gland exploration without use of scintigraphy and gamma probe (160 ± 61 minutes; t = 3.021, P = 0.007). The mean ex vivo lesion-to-background gamma probe count ratio of abnormal parathyroid glands (77.35) was found to be significantly higher than that of all other lesions with abnormal Tc99m-MIBI uptake (5.05) ( U = 10.5, P < 0.0001). Optimal target-to-background ratio is essential for the success of gamma probe-guided parathyroidectomy. This ratio was highly variable among the patients in this study. Individualization of the best surgical exploration time after Tc99m-MIBI injection will improve the surgical success of this operation.

1997-01-01·Przeglad lekarski

Radioizotopowe metody oceny perfuzji i zywotności (metabolizmu) mieśnia serca.

Review

作者: Rogowski, F ; Budlewski, T

Radioisotope methods play a special role in cardiological diagnostics. At present, studies of myocardial perfusion also allow the estimation of cardiomyocyte metabolism. These methods are suitable for the detection of stunned, hibernating or scarred myocardium as well. The radiopharmaceuticals which accumulate in myocardium proportionally to regional blood flow (thallium-201, MIBI-Tc99m, teboroxime-Tc99m, tetrophosmin-Tc99m, furifosmin-tc99m) are used for the estimation of perfusion. In the nuclear medicine departments myocardial perfusion imaging can be performed with planar or tomographic (SPECT) methods. The techniques have high sensitivity (80%, 90%) and specificity (90%, 80%) for detection of coronary artery diseases. The radioisotopic methods have higher sensitivity than other noninvasive techniques (ECG sensitivity-60%, specificity-85%, ECHO sensitivity-81%, specificity-89%). Positron emission tomography is still the "gold" standard for the estimation of myocardial viability. This method uses substrates for different metabolic pathways (acetate-C-11, amino-acids-C-11, fatty acids-C-11, fluorodeoxyglocuse-F-18) labelled with positron emitters. Modifications in thallium protocols make estimation of myocardial metabolism possible. Recently MIBI-Tc99m has also been used in the assessment of myocardial viability. Results of these studies are of great clinical importance. They allow to predict a success of a surgical revascularysation and the return of normal myocardial function.

100 项与 MIBI-Tc99m/Iodine-123 相关的药物交易

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研发状态

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适应症	最高研发状态	国家/地区	公司	日期
肿瘤	临床3期	法国	Nantes University Hospital	2019-01-17
甲状腺结节	临床3期	法国	Nantes University Hospital	2019-01-17
结节性甲状腺肿	临床3期	-	Nantes University Hospital	-