Article Figures & Data
Figures
- FIGURE 1.
Appearance (A) and illustration (B) of pair of laser pointers aligned at right angles. Point O corresponds to center of rotation of detectors.
- FIGURE 2.
Planar images used to select reconstructed regions for SPECT images. (A and C) Early planar images. Line marked 63 in A is centerline in 128 matrix. Centerline passes through right and left external auditory canals. Region between lines 13 and 36 is reconstructed region on SPECT images, excluding salivary glands. (B and D) Delayed planar images. Similarly, centerline passes through both external auditory canals. Reconstructed region for delayed SPECT image is similarly selected between lines 13 and 36.
- FIGURE 3.
SPECT images of a patient: early (A), delayed (B), fusion (C), and subtraction (D).
- FIGURE 4.
A 61-y-old man with 4 hyperplastic glands (patient 10). Glands weighed 300–700 mg. In this patient, 24 slices (1–24) were reconstructed. Slice numbers more and less than 24 were considered to represent superior and inferior parathyroid glands, respectively. (A–D) Early planar image (A), delayed planar image (B), and subtraction SPECT images showing upper (C) and lower (D) parathyroid hyperplasia. Arrow indicates hyperplastic lesion.
- FIGURE 5.
A 74-y-old woman with adenoma (patient 12). Lesion weighed 300 mg. (A–C) Early planar image (A), delayed planar image (B), and subtraction SPECT images (C). Lesion (arrow) was seen in left upper region.
Tables
Blood test Patient no. Age (y) Calcium (mg/dL) (normal, 8.2–10.2 mg/dL) Phosphorus (mg/dL) (normal, 2.7–4.4 mg/dL) ALP (IU/L) (normal, 115–359 IU/L) Internal secretion, PTH (pg/mL) (normal, 10–60 pg/mL) Sex Dialysis Before After Before After Before After Before After 1 37 M + 8.8 7.0 7.5 3.9 483 889 1015 10 2 37 M + 7.1 6.4 4.6 4.3 354 371 274 60 3 54 M + 9.7 8.4 5.8 3.0 403 626 762 140 4 60 F + 9.7 8.0 4.6 3.9 298 304 933 136 5 62 M + 8.2 7.7 4.5 3.8 443 837 778 12 6 58 M + 9.9 9.8 7.3 3.9 363 584 497 7 7 53 M + 10.2 7.2 8.5 6.2 175 263 1,258 126 8 63 M + 9.8 7.8 7.9 4.1 542 748 780 7 9 52 M + 10.0 8.7 6.1 3.4 273 311 533 12 10 61 M + 10.0 7.6 6.3 4.3 245 248 490 5 11 59 M + 9.4 8.7 5.0 3.9 443 439 1,236 10 12 74 F − 10.9 9.0 3.6 3.1 233 239 180 74 13 64 F − 11.1 9.0 2.7 2.7 370 327 180 40 14 56 F − 11.4 9.7 2.9 2.5 287 259 62 39 ALP = alkaline phosphatase; PTH = parathyroid hormone; before = data within 2 wk before surgery; after = data within 5 d after surgery.
Scintigraphy Ultrasonography Surgery/pathology Patient no. Location +/− Size (mm) +/− Histopathology Weight (mg) 1 RU + − Parathyroid hyperplasia 350 RL + 16 × 15 × 15 + Parathyroid hyperplasia 1,650 LU + − Parathyroid hyperplasia 800 LL + 18 × 13 × 11 + Parathyroid hyperplasia 1,100 2 RU + − Parathyroid hyperplasia 1,600 RL + 23 × 10 × 9 + Parathyroid hyperplasia 200 LU + − Parathyroid hyperplasia 1,300 LL + 6 × 5 × 5 + Parathyroid hyperplasia 300 3 RU + 21 × 14 × 9 + Parathyroid hyperplasia 1,600 RL + 13 × 11 × 10 + Parathyroid hyperplasia 500 LU + − No excision LL − 12 × 10 × 6 + Parathyroid hyperplasia 300 4 RU + − Parathyroid hyperplasia 500 RL + 10 × 6 × 5 + Parathyroid hyperplasia 250 LU + − Parathyroid hyperplasia 450 LL + 8 × 8 × 7 + Parathyroid hyperplasia 400 5 RU − − No excision RL − 10 × 6 × 5 + No excision LU + − Parathyroid hyperplasia 1,600 LL + 16 × 12 × 10 + Parathyroid hyperplasia 400 6 RU + − Parathyroid hyperplasia 1,450 RL + 11 × 10 × 8 + Parathyroid hyperplasia 600 LU + − Parathyroid hyperplasia 2,250 LL + 10 × 8 × 7 + Parathyroid hyperplasia 700 7 RU + 6 × 6 × 3 + Parathyroid hyperplasia 950 RL + 11 × 4 × 3 + Parathyroid hyperplasia 350 LU + − Parathyroid hyperplasia 2,050 LL + 12 × 11 × 3 + Parathyroid hyperplasia 350 8 RU + 9 × 8 × 8 + Parathyroid hyperplasia 1,950 RL + 20 × 11 × 14 + Parathyroid hyperplasia 300 LU + 11 × 7 × 7 + Parathyroid hyperplasia 250 LL + 11 × 11 × 6 + Parathyroid hyperplasia 400 9 RU + − Parathyroid hyperplasia 1,500 RL − 23 × 13 × 8 + Parathyroid hyperplasia 900 LU − − Parathyroid hyperplasia 600 LL − − Parathyroid hyperplasia 200 10 RU + 10 × 8 × 5 + Parathyroid hyperplasia 400 RL + 12 × 9 × 7 + Parathyroid hyperplasia 700 LU + 6 × 6 × 8 + Parathyroid hyperplasia 300 LL + 10 × 10 × 4 + Parathyroid hyperplasia 500 11 RU + 8 × 7 × 5 + Parathyroid hyperplasia 100 RL + 13 × 9 × 7 + Parathyroid hyperplasia 200 LU + 6 × 5 × 4 + Parathyroid hyperplasia 50 LL + 17 × 13 × 6 + Parathyroid hyperplasia 500 12 RU − − No excision RL − − No excision LU + 15 × 5 × 3 + Adenoma 300 LL + 16 × 5 × 3 + No excision 13 RU + 20 × 7 × 4 + Adenoma 500 RL − − No excision LU − − No excision LL − 8 × 8 × 4 + No excision 14 RU − − No excision RL + 6 × 4 × 4 + Adenoma 300 LU − − No excision LL − − No excision RU = right upper; RL = right lower; LU = left upper; LL = left lower; + = positive; − = negative.
Ultrasonography(+) (n = 31) Ultrasonography(−) (n = 13) Scintigraphy(+/−) Location RU RL LU LL RU RL LU LL + (n = 40) RU 6 5 RL 10 LU 4 6 LL 9 − (n = 4) RU RL 1 LU 1 LL 1 1 RU = right upper; RL = right lower; LU = left upper; LL = left lower; + = positive; − = negative.
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