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Julian Betancur, Frederic Commandeur, Mahsaw Motlagh, Tali Sharir, Andrew J Einstein, Sabahat Bokhari, Mathews B Fish, Terrence D Ruddy, Philipp Kaufmann, Albert J Sinusas, Edward J Miller, Timothy M Bateman, Sharmila Dorbala, Marcelo Di Carli, Guido Germano, Yuka Otaki, Balaji K Tamarappoo, Damini Dey, Daniel S Berman, Piotr J Slomka
OBJECTIVES: The study evaluated the automatic prediction of obstructive disease from myocardial perfusion imaging (MPI) by deep learning as compared with total perfusion deficit (TPD). BACKGROUND: Deep convolutional neural networks trained with a large multicenter population may provide improved prediction of per-patient and per-vessel coronary artery disease from single-photon emission computed tomography MPI. METHODS: A total of 1,638 patients (67% men) without known coronary artery disease, undergoing stress99m Tc-sestamibi or tetrofosmin MPI with new generation solid-state scanners in 9 different sites, with invasive coronary angiography performed within 6 months of MPI, were studied...
March 12, 2018: JACC. Cardiovascular Imaging
Li Wang, Min-Jie Lu, Lei Feng, Juan Wang, Wei Fang, Zuo-Xiang He, Ke-Fei Dou, Shi-Hua Zhao, Min-Fu Yang
BACKGROUND: The relationship between myocardial viability and angiographic collateral flow is not fully elucidated in ischemic cardiomyopathy (ICM) with coronary artery chronic total occlusion (CTO). We aimed to clarify the relationship between myocardial hibernation, myocardial scar, and angiographic collateral flow in these patients. METHODS AND RESULTS: Seventy-one consecutive ICM patients with 122 CTOs and 652 dysfunctional segments within CTO territories were retrospectively analyzed...
March 7, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
S H Hancox, J D Sinnott, P Kirkland, D Lipscomb, E Owens, D C Howlett
OBJECTIVE: A parathyroid multidisciplinary team meeting was set up at East Sussex Healthcare Trust, from November 2014 to November 2015, in order to improve and streamline services for patients with parathyroid pathology. METHODS: Data were collected on all new referrals for hyperparathyroidism, and on the outcomes for each patient discussed at the meeting, including the number of operations and management outcomes. A survey was sent out to the members of the multidisciplinary team meeting to determine their perception of its effectiveness...
March 2018: Journal of Laryngology and Otology
Denis Agostini, Vincent Roule, Catherine Nganoa, Nathaniel Roth, Raphael Baavour, Jean-Jacques Parienti, Farzin Beygui, Alain Manrique
PURPOSE: We assessed the feasibility of myocardial blood flow (MBF) and flow reserve (MFR) estimation using dynamic SPECT with a novel CZT camera in patients with stable CAD, in comparison with15 O-water PET and fractional flow reserve (FFR). METHODS: Thirty patients were prospectively included and underwent FFR measurements in the main coronary arteries (LAD, LCx, RCA). A stenosis ≥50% was considered obstructive and a FFR abnormal if ≤0.8. All patients underwent a dynamic rest/stress99m Tc-sestamibi CZT-SPECT and15 O-water PET for MBF and MFR calculation...
March 1, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Moska Hamidi, Michael Sullivan, George Hunter, Leena Hamberg, Nancy L Cho, Atul A Gawande, Gerard M Doherty, Francis D Moore, Matthew A Nehs
BACKGROUND: Recurrent primary hyperparathyroidism (PHPT) presents a diagnostic challenge in localizing a hyperfunctioning gland. Although several imaging modalities are available for preoperative localization, 4D-CT is increasingly utilized for its ability to locate both smaller and previously unlocalized lesions. Currently, there is a paucity of data evaluating the utility of 4D-CT in the reoperative setting compared with ultrasound (US) and sestamibi. We aimed to determine the sensitivity of 4D-CT in localizing parathyroid adenomas in recurrent or persistent PHPT...
February 26, 2018: Annals of Surgical Oncology
Ethan Frank, Daniela Ale-Salvo, Joshua Park, Yuan Liu, Alfred Simental, Jared C Inman
BACKGROUND: Thyroid disease occurs more frequently in patients with hyperparathyroidism than the general population and hinders parathyroid localization. Identifying thyroid pathology before operating improves management and avoids the risks of reoperation in the neck. This review assesses imaging studies in patients with hyperparathyroidism and thyroid pathology to identify the ideal imaging methodology for patients with multigland disease. METHODS: Systematic review of original articles reporting sensitivity or positive predictive value (PPV) for one or more imaging modalities in patients with hyperparathyroidism and thyroid disease...
February 20, 2018: Head & Neck
Viola Vaccarino, Samaah Sullivan, Muhammad Hammadah, Kobina Wilmot, Ibhar Al Mheid, Ronnie Ramadan, Lisa Elon, Pratik M Pimple, Ernest V Garcia, Jonathon Nye, Amit J Shah, Ayman Alkhoder, Oleksiy Levantsevych, Hawkins Gay, Malik Obideen, Minxuan Huang, Tené T Lewis, J Douglas Bremner, Arshed A Quyyumi, Paolo Raggi
BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is frequent in patients with coronary artery disease and is associated with worse prognosis. Young women with a previous myocardial infarction (MI), a group with unexplained higher mortality than men of comparable age, have shown elevated rates of MSIMI, but the mechanisms are unknown. METHODS: We studied 306 patients (150 women and 156 men) ≤61 years of age who were hospitalized for MI in the previous 8 months and 112 community controls (58 women and 54 men) frequency matched for sex and age to the patients with MI...
February 20, 2018: Circulation
Monica Gupta, Lalita Singhal, Akshay Kumar
Multiple osteolytic lesions are usually associated with metastatic involvement of the bone; however, metabolic bone diseases should also be included in the differential diagnosis. In this study, we describe a case of primary hyperparathyroidism (PHPT) with multiple osteolytic lesions that was diagnosed initially as having metastatic bone involvement. The laboratory results showed hypercalcemia and raised alkaline phosphatase along with fibrosis in the bone marrow biopsy with no increase in tumor markers and normal serum protein electrophoresis...
February 15, 2018: Journal of Adolescent and Young Adult Oncology
Andre Navarro, Josanne Vassallo, Joseph Galea
An elderly lady was diagnosed with primary hyperparathyroidism after being admitted to hospital with pyelonephritis and constipation. A sestamibi parathyroid scan demonstrated increased uptake in the upper mediastinum, suggesting an ectopic mediastinal parathyroid adenoma. The 4-mm adenoma was successfully removed through a mini-sternotomy incision using a gamma probe to identify the gland from the surrounding tissue. The patient made an uneventful recovery.
September 2017: Case Reports in Oncology
Peipei Xu, Xiaotian Xia, Meifang Li, Minggao Guo, Zhili Yang
BACKGROUND: Parathyroid cysts are relatively uncommon lesions and are often misdiagnosed. We evaluate our experience in the diagnosis of and therapy to correct parathyroid cystic lesions. METHODS: We retrospectively reviewed a series of 32 patients with parathyroid cysts who were admitted to our department between July 2011 and November 2016. Clinical pathological features of the patients, including age, gender, location, size, ultrasonography, histopathology, surgery, and follow-up, were analyzed...
February 6, 2018: BMC Surgery
Yu-Kwang Donovan Tay, Randy Yeh, Jennifer H Kuo, Catherine McManus, James A Lee, John P Bilezikian
CONTEXT: Accurate preoperative localization of abnormal parathyroid tissue aids importantly in minimally invasive parathyroidectomy in patients with primary hyperparathyroidism. Vitamin D deficiency may possibly influence the success and characteristics of pre-operative localization because it is associated with more active disease and possibly larger adenomas. This could increase the sensitivity of the sestamibi to identify abnormal parathyroid tissue, but earlier reports are conflicting...
February 5, 2018: Endocrine
Mohamed Shawgi, Tamir Ali, Matthew Scott, George Petrides
We report the case of a 74-year-old woman with primary hyperparathyroidism who underwent 99m-technetium-sestamibi single photon emission computed tomography-computed tomography for preoperative localization of parathyroid adenoma. Unexpected focal sestamibi uptake was observed at a 5 cm submucosal tumor arising from the greater curve of the stomach. The patient underwent partial gastrectomy and the histological and immunohistochemical findings were consistent with the diagnosis of gastric schwannoma.
January 2018: World Journal of Nuclear Medicine
Denise Mayumi Tanaka, Luciano Fonseca Lemos de Oliveira, José Antônio Marin-Neto, Minna Moreira Dias Romano, Eduardo Elias Vieira de Carvalho, Antonio Carlos Leite de Barros Filho, Fernando Fonseca França Ribeiro, Jorge Mejia Cabeza, Carla Duque Lopes, Camila Godoy Fabricio, Norival Kesper, Henrique Turin Moreira, Lauro Wichert-Ana, André Schmidt, Maria de Lourdes Higuchi, Edécio Cunha-Neto, Marcus Vinícius Simões
BACKGROUND: Myocardial perfusion defects (MPD) due to coronary microvascular dysfunction is frequent in chronic Chagas cardiomyopathy (CCC) and may be involved with development of myocardial damage. We investigated whether MPD precedes left ventricular systolic dysfunction and tested the hypothesis that prolonged use of dipyridamole (DIPY) could reduce MPD in an experimental model of CCC in hamsters. METHODS AND RESULTS: We investigated female hamsters 6-months after T...
February 1, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Gilles Barone-Rochette, Feras Zoreka, Loïc Djaileb, Nicolas Piliero, Alex Calizzano, Jean Louis Quesada, Alexis Broisat, Laurent Riou, Jacques Machecourt, Daniel Fagret, Gerald Vanzetto, Catherine Ghezzi
BACKGROUND: The aim of this study was to determine the diagnostic accuracy of stress thallium-201/rest technetium-99m-sestamibi sequential dual-isotope high-speed myocardial perfusion imaging (DI-HS-MPI) against invasively determined fractional flow reserve (FFR). METHODS: Fifty-four consecutive patients prospectively underwent DI-HS-MPI before invasive coronary angiography. Perfusion was scored visually by summed stress score on a patient and coronary territory basis...
January 29, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
P H Pucher, N C Carter, B C Knight, Skc Toh, V Tucker, S J Mercer
Background Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism is dependent upon accurate prediction of single-gland disease on the basis of preoperative imaging and biochemistry. The aims of this study were to validate currently available predictive models of single-gland disease in two UK cohorts and to determine if these models can facilitate MIP. Methods This is a retrospectively cohort study of 624 patients who underwent parathyroidectomy for primary hyperparathyroidism in two centres between July 2008 and December 2013...
January 24, 2018: Annals of the Royal College of Surgeons of England
Noman Ahmad, Mona Bahasan, Balgees Abdulhadi Abdullah Al-Ghamdi, Halah Faleh Al-Enizi, Ali Saeed Al-Zahrani
Neonatal severe hyperparathyroidism (NSHPT) is a rare autosomal recessive disease. Children present within the first 6 months of life and more commonly in the first few weeks. Common presentation is poor feeding, polyuria, dehydration, lethargy, failure to thrive, hypotonia, gastrointestinal dysmotility, osteopenia and symptoms of respiratory distress due to a poorly developed chest cage. We present a case of a 2-month old girl with severe hypercalcemia and hyperparathyroidism. She was found to have a novel homozygous mutation in the acceptor splicing site of intron 4 (c...
September 2017: Clinical Cases in Mineral and Bone Metabolism
Jake Hiebert, Cameron Hague, Shangmei Hou, Sam M Wiseman
BACKGROUND: The objective of this study was to evaluate the performance of dual-energy computed tomography (DECT) for preoperative parathyroid tumor (PT) localization in primary hyperparathyroid (PHP) patients. METHODS: A retrospective review was carried out of the medical records of all PHP patients who underwent ultrasound (US), Tc-99m sestamibi noncontrast single photon emission computed tomography (CT-MIBI), DECT and parathyroidectomy at a single center. RESULTS: The sensitivities and accuracies for preoperative PT localization in the 97 patient study population were: US 40% and 93%, CT-MIBI 64...
January 5, 2018: American Journal of Surgery
Albena D Botushanova, Nikolay P Botushanov, Marianna P Yaneva
Considered rare disease in the past, primary hyperparathyroidism (PHPT) has dramatically increased in incidence over the past thirty years with the introduction of routine calcium measurements; it is now approximately 42 per 100 000 persons. By far, the most common lesion found in patients with PHPT is the solitary parathyroid adenoma, occurring in 85%-90% of patients, while in the rest 10%- 15% primary hyperplasia of the parathyroid glands is present. Currently, the most widely used surgical approach is minimally invasive parathyroidectomy which is associated with less post-surgery complications and shorter operation time...
December 20, 2017: Folia Medica
Mads Ryø Jochumsen, Peter Iversen, Anne Kirstine Arveschoug
A case of follicular thyroid cancer with intense focal Methionine uptake on 11C-Methionine PET/CT is reported here. The use of 11C-Methionine PET in differentiated thyroid cancer is currently being investigated as a surrogate tracer compared to the more widely used 18F-FDG PET. This case illustrates the potential incremental value of this modality, not only in the localizing of parathyroid adenoma, but also indicating that 11C-Methionine PET might have a potential of increasing the pretest likelihood of thyroid malignancy in a cold nodule with highly increased Sestamibi uptake...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Sebastijan Rep, Marko Hocevar, Janja Vaupotič, Urban Zdesar, Katja Zaletel, Luka Lezaic
Parathyroid subtraction scintigraphy is the most commonly used imaging method for localization of hyperfunctioning parathyroid glands (HPG) in primary hyperparathyroidism, a common endocrine disorder. Hybrid (SPECT/CT) imaging with 99mTc-sestaMIBI (MIBI) at an early and delayed phase (dual-phase imaging) may be the most accurate conventional imaging approach, but includes additional radiation exposure due to added CT imaging. Recently, 18F-choline (FCH) PET/CT was introduced for HPG imaging, which can also be performed using the dual-phase approach...
January 17, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
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