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POSTER PRESENTATIONS
Posterpresentations
September 2018, 17(5):49-342
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EDITORIALS
When was the Last Time You did Something for the First Time?
Ajit Kumar Padhy
September-December 2012, 11(3):99-100
DOI
:10.4103/1450-1147.103404
PMID
:23372444
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ORIGINAL ARTICLES
Detection of primary malignancy and metastases with FDG PET/CT in patients with cholangiocarcinomas: Lesion-based comparison with contrast enhanced CT
Youssef Elias, Aladin T Mariano, Yang Lu
September-December 2016, 15(3):161-166
DOI
:10.4103/1450-1147.167605
PMID
:27651736
The current National Comprehensive Cancer Network (NCCN) Guidelines consider the role of 2-deoxy-2-
18
F-fluoro-d-glucose positron emission tomography/computer tomography (FDG PET/CT) in the evaluation of cholangiocarcinoma (CCA) as "uncertain," and have recommended contrast enhanced computed tomography (CECT) but not FDG PET/CT as a routine imaging test for CCA workup. We set out to compare the diagnostic performance of FDG PET/CT and CECT in patients with CCA. The retrospective study included patients with CCA who underwent FDG PET/CT and CECT within 2-month interval between 2011 and 2013 in our hospital. Lesion-based comparison was conducted. Final diagnoses were made based on the composite clinical and imaging data with minimal 6-month follow-up. A total of 18 patients with 28-paired tests were included. There is a total of 142 true malignant lesions as revealed by the 6-paired pre-treatment and 22-paired post-treatment tests. On a lesion-based analysis, the sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), and accuracies of PET/CT and CECT for detection of CCA were 96.5%, 55.5%, 97.2%, 50.0%, 94.1% and 62.2%, 66.7%, 96.7%, 10.0%, 62.5%, respectively. FDG PET/CT detected more intrahepatic malignant and extrahepatic metastases; and had significant higher sensitivity, NPV, and accuracy than CECT, while similar in specificity and PPV. No true positive lesion detected on CECT that was missed on PET/CT, and none of the false negative lesions on PET/CT were detected on CECT. Six patients had paired pretreatment tests, and FDG PET/CT results changed planned management in three patients. Our data suggest that FDG PET/CT detect more primary and metastatic lesions and lead to considerable changes in treatment plan in comparison with CECT.
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LETTERS TO EDITOR
Journal Impact Factor: Its Use, Significance and Limitations
Mohit Sharma, Anurag Sarin, Priyanka Gupta, Shobhit Sachdeva, Ankur V Desai
May-August 2014, 13(2):146-146
DOI
:10.4103/1450-1147.139151
PMID
:25191134
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ABSTRACTS
Abstracts of Invited Lectures
January-June 2011, 10(1):26-59
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WELCOME MESSAGE
Welcome Message
Emerita Andres-Barrenechea
November 2013, 12(4):181-181
DOI
:10.4103/1450-1147.119938
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ABSTRACTS
Scientific Programme
April 2015, 14(4):1-11
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REVIEW ARTICLE
Assessment Lumboperitoneal or Ventriculoperitoneal Shunt Patency by Radionuclide Technique: A Review Experience Cases
Sunanta Chiewvit, Sarun Nuntaaree, Potjanee Kanchaanapiboon, Pipat Chiewvit
May-August 2014, 13(2):75-84
DOI
:10.4103/1450-1147.139135
PMID
:25191120
Hydrocephalus-related symptoms that worsen after shunt placement may indicate a malfunctioning or obstructed shunt. The assessment of shunt patency and site of obstruction is important for planning of treatment. The radionuclide cerebrospinal fluid (CSF) shunt study provides a simple, effective, and low-radiation-dose method of assessing CSF shunt patency. The radionuclide CSF shuntography is a useful tool in the management of patients presenting with shunt-related problems not elucidated by conventional radiological examination. This article described the imaging technique of ventriculoperitoneal (VP) shunt and lumbar puncture (LP) shunt. The normal finding, abnormal finding of completed obstruction and partial obstruction is present by our cases experience. The radiopharmaceutical (Tc-99m diethylenetriaminepentaacetic acid) was injected via the reservoir for VP shunt and via lumbar puncture needle in subarachnoid space for LP shunt, then serial image in the head and abdominal area. The normal function of VP and LP shunt usually rapid spillage of the radioactivity in the abdominal cavity diffusely. The patent proximal tube VP shunt demonstrates ventricular reflux. The early image of patent LP shunt reveals no activity in the ventricular system contrast to distal LP shunt reveals early reflux of activity in the ventricular system. The completed distal VP and LP shunt obstruction show absence of tracer in the peritoneal area or markedly delayed appearance of abdominal activity. The partial distal VP and LP shunt obstruction recognized by slow transit or accumulation of tracer at the distal end or focal tracer in the peritoneal cavity near the tip of distal shunt. The images of the normal and abnormal CSF shunt as describe before are present in the full paper. Radionuclide CSF shuntography is a reliable and simple procedure for assessment shunt patency.
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CASE REPORT
Bone Scan "Hot Spot" at the Superior Lateral Orbital Margin Fronto-zygomatic Suture Uptake Characterized with Tc-99m MDP SPECT/CT
SP Thang, A. E. H Tan, A. S. W Goh
July-December 2011, 10(2):139-140
DOI
:10.4103/1450-1147.89782
PMID
:22144872
Findings of a solitary "hot spot" at the superior lateral orbital margin on bone scan scintigraphy is not uncommonly seen, and is often dismissed as a benign lesion. However, the exact etiology is indeterminate. We present two cases in which hybrid single photon emission computed tomography/computed tomography imaging was able to characterize and localize this uptake, demonstrating correlation to the right fronto-zygomatic suture.
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REVIEW ARTICLE
Targeted alpha-particle therapy in neuroendocrine neoplasms: A systematic review
Thuan Tzen Koh, Eva Bezak, David Chan, Gabrielle Cehic
October-December 2021, 20(4):329-335
DOI
:10.4103/wjnm.wjnm_160_20
Neuroendocrine neoplasms (NENs) are a very diverse group of tumors with a worldwide rise in incidence. Systemic therapy remains the mainstay treatment for unresectable and/or metastatic NENs.
177
Lu-DOTATATE, a radiopharmaceutical which emits beta particles, has emerged as a promising therapy for metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, limited treatment options are available particularly after the failure of
177
Lu-DOTATATE therapy. This review aims to identify and summarize the available evidence for, and potential adverse events of, targeted alpha-particle therapy (TAT) in the treatment of metastatic NENs, specifically GEP-NENs. The MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases were searched. Two articles which met the inclusion criteria were identified and included in the review. Putative radiopharmaceuticals that can be considered for metastatic NEN treatment include
225
Actinium (
225
Ac)-DOTATATE and
213
Bismuth (
213
Bi)-DOTATOC. There was evidence of partial response using both radiopharmaceutical agents without significant hematological, renal, or hepatotoxicity. Future studies should consider longer term, randomized controlled trials investigating the role of TAT, in particular,
225
Ac-DOTATATE, in the treatment of metastatic NENs.
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EDITORIAL
Excellence is the enemy of good
John Buscombe
September-December 2014, 13(3):147-148
DOI
:10.4103/1450-1147.144811
PMID
:25538483
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ABSTRACTS
Speakers Abstracts
November 2013, 12(4):186-220
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REVIEW ARTICLE
Nuclear medicine in prostate cancer: A new era for radiotracers
Vincenzo Cuccurullo, Giuseppe Danilo Di Stasio, Luigi Mansi
April-June 2018, 17(2):70-78
DOI
:10.4103/wjnm.WJNM_54_17
PMID
:29719480
Natural history of prostate cancer (PCa) is extremely variable, as it ranges from indolent and slow growing tumors to highly aggressive histotypes. Genetic background and environmental factors co-operate to the genesis and clinical manifestation of the tumor and include among the others race, family, specific gene variants (i.e., BRCA1 and BRCA2 mutations), acute and chronic inflammation, infections, diet and drugs. In this scenario, remaining actual the clinical interest of bone scan (BS) in detecting skeletal metastases, an important role in diagnostic imaging may be also carried out by, positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance imaging (PET/MRI), which combine morphological information provided by CT and MRI with functional and metabolic data provided by PET acquisitions. With respect to PET radiotracers, being ancillary the usefulness of F-18 fluoro-deoxyglucose and not yet demonstrated the cost-effectiveness of F-18 Fluoride respect to BS, the main role is now played by choline derivatives, in particular by 11C-choline and 18F-fluorocholine. More recently, a greater interest for both diagnostic and therapeutic purposes has been associated with radiotracers directed to prostate-specific membrane antigen (PSMA), a transmembrane protein expressed on the cell surface, which showed high selective expression in PCa, metastatic lymph nodes and bone metastases. Several PSMA-targeted PET tracers have been developed many of which showing promising results for accurate diagnosis and staging of primary PCa and re-staging after biochemical recurrence, even in case of low prostate specific antigen values. In particular, the most widely used PSMA ligand for PET imaging is a
68
Ga-labelled PSMA inhibitor,
68
Ga-PSMA-HBED-CC (
68
Ga-PSMA-11).
99m
Tc-HYNIC-Glu-Urea-A for single photon emission computed tomography, and
177
Lu-PSMA-617 for radioligand therapy has also been applied in humans, with interesting preliminary results related to a possible theranostic approach. A potential role of PSMA radioligands in radio-guided surgery has also been proposed.
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CASE REPORTS
Zinner's Syndrome
J Kuo, C Foster, DK Shelton
January-June 2011, 10(1):20-22
DOI
:10.4103/1450-1147.82115
PMID
:22034579
A 52-year-old male was subjected to an F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) study for the evaluation of newly diagnosed non-Hodgkin's lymphoma. An incidental non-FDG avid urinary bladder mass was detected, as well as an absent kidney. Ureterocele was suspected, but subsequently a seminal vesicle cyst was confirmed on a CT urogram.
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ORIGINAL ARTICLES
Investigation of fetal absorbed dose in V/Q scan in three trimesters of pregnancy using Monte Carlo simulation
Shahabeddin Vakili, Daryoush Shahbazi-Gahrouei, Parastoo Pourasbaghi, Elham Raeisi
October-December 2021, 20(4):342-348
DOI
:10.4103/wjnm.WJNM_122_20
The ventilation/perfusion (V/Q) single-photon emission computed tomography is the first method of diagnosis for pulmonary embolism in pregnant women. This study aimed to calculate the fetal absorbed dose and compare to recommended values in V/Q scan at three trimesters of pregnancy by Monte Carlo simulation (code MCNPX) using simulated phantoms, based on the adult female MIRD phantom. The collection of pregnant women phantoms (that of Stabin) was designed with changes in the MIRD phantom. Source organs were defined for each of the radiopharmaceuticals used in two scans,
133
Xe and
81m
Kr for the lung and bladder and technetium diethylene-triamine-pentaacetate (
99m
Tc-DTPA) aerosol for lung ventilation scan. Also, technetium macroaggregated albumin (
99m
Tc-MAA) for lung ventilation scan, lung, bladder, and liver. Fetal absorbed dose was calculated and evaluated for the administration radiopharmaceuticals using the MCNP simulation output. For 200 MBq
99m
Tc-MAA, fetal absorbed dose was 1.01–1.97 mGy, which is higher than the values recommended by International Commission on Radiological Protection (ICRP). The same fetal absorbed dose was found for activities of 54 and 70 MBq in the third trimester. For
99m
Tc-DTPA-aerosol, fetal absorbed dose as a ventilation tracer was within the permitted range. For
133
Xe and
81m
Kr, it was negligible. It is concluded that the fetus received the highest absorbed dose in the third trimester of pregnancy. For this reason, in this period of pregnancy, it is recommended to use the lower administration activity and her awareness must be done.
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Fixed 30 mCi (1110 MBq)
131
I-iodine therapy in autonomously functioning nodules: Single toxic nodule as a predictive factor of success
Lívia Stela Bueno Pereira, Cinthia Minatel Riguetto, Arnaldo Moura Neto, Marcos Antônio Tambascia, Celso Darío Ramos, Denise Engelbrecht Zantut-Wittmann
October-December 2021, 20(4):349-354
DOI
:10.4103/wjnm.wjnm_150_20
Aims:
The aim of this study is to evaluate the efficacy of a fixed 30 mCi (1110 MBq)
131
I-iodine dose for the treatment of hyperthyroidism due to uninodular or multinodular toxic goiter and identify predictors of success.
Materials and Methods:
Fifty-nine patients diagnosed with nonautoimmune toxic goiter were treated with a fixed 30 mCi dose of
131
I-iodine and were followed at a tertiary service between 2000 and 2016. The therapy was considered successful if the patient reached euthyroidism or hypothyroidism without needing an extra
131
I-iodine dose or antithyroid drugs for at least 1 year after the radioiodine therapy (RIT).
Results:
Patients with a single toxic nodule were younger at diagnosis (52 vs. 63 years;
P
= 0.007), presented a shorter disease duration until RIT (2 vs. 3.5 years;
P
= 0.007), smaller total thyroid volume (20 vs. 82 cm
3
;
P
= 0.044), and lower pre-RIT thyroid uptake (
P
= 0.043) than patients with multinodular goiter. No significant difference was seen with antithyroid drug use, thyroid-stimulating hormone and free thyroxine level, and follow-up after RIT. After RIT, 47 patients (79.66%) met the success criteria, and 12 (20.33%) remained hyperthyroid. Among the success group, 32 (68.08%) reached euthyroidism, while 31.92% developed hypothyroidism after 1 year. Patients with single toxic nodules who achieved success after RIT presented smaller nodules (2.8 vs. 5.75 cm;
P
= 0.043), while the pre-RIT thyroid uptake was higher among patients with multinodular toxic goiter who achieved success after RIT (5.5% vs. 1.5%;
P
= 0.007). A higher success rate was observed among patients with a single toxic nodule than those with a toxic multinodular goiter (92.3% vs. 55%;
P
= 0.001), and a single toxic nodule presentation was found to be an independent predictor of success (
P
= 0.009).
Conclusions:
The fixed 30 mCi
131
I-iodine dose was particularly effective in the group of patients with single autonomously functioning nodule rather than the group with multiple nodules. A single toxic nodule was an independent predictor of treatment success.
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Technetium-99m methylene diphosphonate bone scan in evaluation of insufficiency fractures – A pictorial assay and experience from South India
Madhur Kumar Srivastava, Ram Manohar Pagala, Vinodh Kendarla, Kavitha Nallapareddy
October-December 2021, 20(4):355-360
DOI
:10.4103/wjnm.wjnm_155_20
Insufficiency fractures (IFs) can be challenging to diagnose due to varied presentations, and sometimes, it changes the course of treatment, as in cancer patients in whom it has to be differentiated with metastatic disease. We present the role of Technetium 99m methylene diphosphonate (
99m
Tc-MDP) bone scan, which is a low-cost, simple to perform, whole body diagnostic investigation in the diagnosis of IFs. This is a retrospective analysis of all patients who underwent a
99m
Tc-MDP bone scan in a tertiary care teaching hospital during 2013–2017 and were diagnosed as having an IF on bone scan. The bone scans were performed on a dual-head gamma camera using low-energy high-resolution collimators. Of all the bone scan performed during 2013–2017, a total of 138 patients with a mean age of 57.5 ± 14.7 years were diagnosed as having IFs based on bone scan and final clinical diagnosis. Among them, the most common complaint was regional bony pain in 62% of patients, while the most common cause was osteoporosis in 47% of patients, both postmenopausal and senile osteoporosis. In all, 265 sites of fractures were identified with a fracture average of 1.9/patient, the most common site being dorsolumbar vertebrae, followed by ribs and lower limb bones. Many unusual sites were also identified such as talus, sternum, clavicle, and scapula.
99m
Tc-MDP bone scan, being noninvasive whole-body imaging, is a useful investigation for evaluation of IFs and in correlation with biochemical analysis and other imaging can be used to determine the etiology of IF.
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REVIEW ARTICLES
Current Practice and Recommendation for Presurgical Cardiac Evaluation in Patients Undergoing Noncardiac Surgeries
Subramanyam Padma, P Shanmuga Sundaram
January-April 2014, 13(1):6-15
DOI
:10.4103/1450-1147.138568
PMID
:25191106
The increasing number of patients with coronary artery disease (CAD) undergoing major noncardiac surgery justifies guidelines concerning preoperative cardiac evaluation. This is compounded by increasing chances for a volatile perioperative period if the underlying cardiac problems are left uncorrected prior to major noncardiac surgeries. Preoperative cardiac evaluation requires the clinician to assess the patient's probability to have CAD, severity and stability of CAD, placing these in perspective regarding the likelihood of a perioperative cardiac complication based on the planned surgical procedure. Coronary events like new onset ischemia, infarction, or revascularization, induce a high-risk period of 6 weeks, and an intermediate-risk period of 3 months before performing noncardiac surgery. This delay is unwarranted in cases where surgery is the mainstay of treatment. The objective of this review is to offer a comprehensive algorithm in the preoperative assessment of patients undergoing noncardiac surgery and highlight the importance of myocardial perfusion imaging in risk stratifying these patients.
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Radiosynovectomy in the Therapeutic Management of Arthritis
Liepe Knut
January 2015, 14(1):10-15
DOI
:10.4103/1450-1147.150509
PMID
:25709538
Radiosynovectomy is a well-established therapy in arthritis and involves an intra-articular injection of small radioactive particles to treat a synovitis. In Europe, frequent indications are rheumatoid and poly-arthritis. Especially in Germany radiosynovectomy is the second common therapy in Nuclear Medicine with about 40,000-60,000 treated joints per year. In Spain, USA, Turkey, Argentines and Philippines the therapy is more use in hemophilic arthritis with excellent results. Especially in developing countries with low availability of clotting factors, the radiosynovectomy represent a cost effective therapeutic option for repeated bleedings in hemophilic arthropathy. The special focus in these countries is maintaining of mobility and work ability. Often only the knee and medium joints (ankle, elbow and shoulder) are treated using yttrium-90, rhenium-186 or phosphorus-32. However, in rheumatoid arthritis most common affected joints are the fingers. For the treatment in these small joints, erbium-169 is necessary. Unfortunately, erbium-169 is only available in Europe. Further indications for radiosynovectomy are osteoarthritis and the articular effusion after joint replacement. The reported response rates in rheumatoid and poly-arthritis range from 60% to 80% depends from the stage of previous arthrosis. The best effectiveness of therapy was observed in hemophilic arthritis with response rate of 90% and significant reducing of bleeding frequency. The therapy is well-tolerated with low rate of side effects. In respect of the specific uptake of particles in the synovia and short range of beta radiation, the radiation exposure outside the joint is very low. The radiosynovectomy has efforts in comparison to surgical synovectomy: it's a minor intervention with low costs; and simultaneous treatments of multiple joints or treatment in short intervals are possible. The presented paper summarized the published papers and reports our own experiences in >15,000 treated joints.
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ABSTRACTS
Abstracts of Invited Lectures
July-December 2011, 10(2):142-177
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ORIGINAL ARTICLES
99m
Tc-MIBI Whole Body Scan: A Potentially Useful Technique for Evaluating Metabolic Bone Disease
AM Al-Shammari, AH Elgazzar, Rasha A Ashkanani
January-March 2013, 12(1):8-13
DOI
:10.4103/1450-1147.113934
PMID
:23961249
Metabolic bone disease due to hyperparathyroidism is characterized by increased bone resorption and new bone formation.
99m
Tc- hexakis-2-methoxyisobutylisonitrile (
99m
Tc MIBI) accumulation is controlled by metabolic function and cell viability. To investigate, for the first time, the potential of whole body
99m
Tc MIBI scan for detecting, visually and with the aid of quantitative analysis, bony changes associated with hyperparathyroidism. Eighty-six patients with hyperparathyroidism, referred routinely for parathyroid localization, were included in this case-control prospective study. Each patient was injected with 20-25 mCi of
99m
Tc MIBI. Routine anterior cervico-thoracic images were obtained for parathyroid localization. Two extra whole body images were acquired and assessed visually and by drawing regions of interest over the mandible, sternum, femur, humeri, spine, and the soft tissue adjacent to the bone. The ratios of bone to soft tissue were calculated and compared to ratios drawn in a control group routinely referred for cardiac imaging and injected with
99m
Tc MIBI, after confirming the absence of any bone disease. The visual interpretation of the scans showed 48 patients to have increased bone uptake. Quantitative assessment showed significant difference between the mean ratios of the case and control groups. The Kruskal-Wallis test showed significant agreement between visual and quantitative ratios drawn from delayed right and left femora and left humerus images (
P
< 0.05).
99m
Tc MIBI whole body imaging is a potentially useful technique for assessing metabolic bone disease associated with hyperparathyroidism. Quantitative analysis helped in confirming the visual findings.
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ABSTRACTS
Abstracts of Poster Presentations (Chemistry)
January-June 2011, 10(1):73-89
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DOSIMETRY
Dosimetric Considerations in Radioimmunotherapy and Systemic Radionuclide Therapies: A Review
Kelvin S.H Loke, Ajit K Padhy, David C.E Ng, Anthony S.W Goh, Chaitanya Divgi
July-December 2011, 10(2):122-138
DOI
:10.4103/1450-1147.89780
PMID
:22144871
Radiopharmaceutical therapy, once touted as the "magic bullet" in radiation oncology, is increasingly being used in the treatment of a variety of malignancies; albeit in later disease stages. With ever-increasing public and medical awareness of radiation effects, radiation dosimetry is becoming more important. Dosimetry allows administration of the maximum tolerated radiation dose to the tumor/organ to be treated but limiting radiation to critical organs. Traditional tumor dosimetry involved acquiring pretherapy planar scans and plasma estimates with a diagnostic dose of intended radiopharmaceuticals. New advancements in single photon emission computed tomography and positron emission tomography systems allow semi-quantitative measurements of radiation dosimetry thus allowing treatments tailored to each individual patient.
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6,911
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21
ABSTRACTS
Abstracts of Poster Presentations (Ga-68 Imaging)
January-June 2011, 10(1):90-97
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REVIEW ARTICLE
Investigating patients with normocalcemic hyperparathyroidism: When is a parathyroid scintigraphy indicated?
Elias E Mazokopakis, Spyridon-Nikitas I Skarakis
July-September 2019, 18(3):227-231
DOI
:10.4103/wjnm.WJNM_61_18
PMID
:31516364
In clinical practice, physicians often encounter patients with persistent elevated serum parathyroid hormone levels and normal serum calcium levels, a state known as normocalcemic hyperparathyroidism (NHPT). The investigation of NHPT cases can lead to unnecessary use of parathyroid scintigraphy (PS) and consequently unnecessary health-care costs. In this clinical review, the most common causes of NHPT and the possible indications for PS performance in such cases are mainly presented and discussed.
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