@article {Tomas189, author = {Maria B. Tomas and Paul V. Pugliese and Gene G. Tronco and Charito Love and Christopher J. Palestro and Kenneth J. Nichols}, title = {Pinhole Versus Parallel-Hole Collimators for Parathyroid Imaging: An Intraindividual Comparison}, volume = {36}, number = {4}, pages = {189--194}, year = {2008}, doi = {10.2967/jnmt.108.055640}, publisher = {Society of Nuclear Medicine}, abstract = {This study was undertaken to determine the effects of collimators on the accuracy of preoperative sestamibi parathyroid imaging of the neck. Methods: Forty-nine patients with primary hyperparathyroidism underwent preoperative 99mTc-sestamibi parathyroid imaging. The protocol included early and late pinhole and parallel-hole imaging. One experienced nuclear physician, without knowledge of other test results or final diagnoses, interpreted studies. For both pinhole and parallel-hole images, focally increased sestamibi accumulation outside the normal tracer biodistribution that persisted or increased in intensity from early to late images was interpreted as positive for a parathyroid lesion. Final diagnoses were operatively confirmed in all patients. Results: Fifty-four parathyroid lesions were resected from the 49 patients. Forty-five patients had single-gland disease. Four patients had multigland disease: 3 had 2 lesions and 1 had 3 lesions. Median lesion weight was 840 mg. Pinhole imaging was significantly more sensitive than parallel-hole imaging (89\% vs. 56\%; P = 0.0003) for all 54 lesions. Specificity did not significantly differ between pinhole and parallel-hole imaging (93\% vs. 96\%, P = 0.29). Pinhole imaging was significantly more sensitive than parallel-hole imaging for lesions above (100\% vs. 68\%, P = 0.003) and below (77\% vs. 42\%, P = 0.03) the median weight and for single-gland disease (96\% vs. 67\%, P = 0.001). Pinhole imaging also was more sensitive for multigland disease, although the difference was only marginally significant (55\% vs. 0\%, P = 0.037). Conclusion: Because sensitivity is significantly higher, sestamibi parathyroid imaging of the neck should be performed with a pinhole collimator.}, issn = {0091-4916}, URL = {https://tech.snmjournals.org/content/36/4/189}, eprint = {https://tech.snmjournals.org/content/36/4/189.full.pdf}, journal = {Journal of Nuclear Medicine Technology} }