SYSTEMATIC REVIEW AND META ANALYSIS OF THE LITERATURE CONCERNING DUAL ISOTOPE IMAGING OF THE THYROID AND PARATHYROID.

AUTHORS:
B. O'Flynn (Cork, Ireland) , S. Paul (Cork, Ireland) , P. Redmond (Cork, Ireland)
Background:
Until recent advances in preoperative imagining, excision of parathyroid adenomas required bilateral exploration of the neck. With the advent of advancing preoperative imaging, and intraoperative parathyroid assay, a minimally invasive approach is now used. This Study aims to determine the increase in accuracy in identifying the location of parathyroid adenomas with the dual-tracer simultaneous-acquisition method compared with the single-tracer, dual-phase protocol that is currently predominant.
Methods:
Existing peer-reviewed journals were searched to identify trials and studies that evaluated dual-isotope scanning. Online research databases PubMed, SCOPUS, and Cochrane were analysed.
Results:
The primary outcome was the success rate of dual radioisotope imagining, defined as sensitivity and specificity. Results after systematic evaluation of potentially relevant articles, 12 studies were downloaded and 7 studies, consisting of 3,701 patients, met the study criteria. Dual radioisotope imaging has statistically significant higher diagnostic accuracy than dual-phase CT as first-line imagining
Conclusions:
In preoperative assessment of primary hyperparathyroidism and to guide surgery, dual-isotope subtraction imagining is currently the most accurate technique.