Name of the Procedure:

Parathyroid Planar Imaging (including Subtraction, when Performed); with Tomographic (SPECT), and Concurrently Acquired Computed Tomography (CT) for Anatomical Localization

Summary

Parathyroid planar imaging with SPECT and CT is a diagnostic procedure used to locate abnormal parathyroid glands. It combines nuclear imaging (SPECT) and CT scans to provide detailed anatomical and functional information, aiding in accurate diagnosis and treatment planning.

Purpose

This procedure is designed to identify overactive or abnormal parathyroid glands. The primary goals are to detect hyperparathyroidism, assist in surgical planning, and determine the specific location and size of the affected glands.

Indications

• Elevated calcium levels in the blood (hypercalcemia)
• Symptoms of hyperparathyroidism such as fatigue, muscle weakness, or bone fractures
• Patients with suspected parathyroid adenomas or hyperplasia
• Individuals preparing for parathyroid surgery

Preparation

• Follow specific dietary restrictions if instructed by your healthcare provider.
• Inform your doctor about all medications you are taking; some may need to be paused.
• Diagnostic blood tests may be required to measure calcium and parathyroid hormone levels.

Procedure Description

1. Preparation: The patient is given a radiopharmaceutical agent intravenously to help visualize the parathyroid glands.
2. Imaging: After a waiting period, the patient is positioned on the imaging table.
3. SPECT Imaging: A series of images are taken using Single Photon Emission Computed Tomography (SPECT) to capture functional data.
4. CT Imaging: Concurrently, a computed tomography (CT) scan is performed to provide detailed anatomical information.
5. Subtraction Imaging (if performed): Images are processed to subtract signals from surrounding tissues, isolating the parathyroid glands.
6. Analysis: The combined SPECT and CT images are analyzed to identify any abnormalities.

Duration

The entire procedure typically takes about 1 to 2 hours, including preparation and imaging time.

Setting

This procedure is usually performed in a hospital’s nuclear medicine department or an outpatient radiology clinic.

Personnel

• Nuclear medicine physician
• Radiologist
• Nuclear medicine technologist
• Radiologic technologist

Risks and Complications

• Exposure to low levels of radiation from the radiopharmaceutical and CT scan
• Rare allergic reactions to the radiopharmaceutical
• Possible discomfort from lying still during the imaging process

Benefits

• High accuracy in locating abnormal parathyroid glands
• Enhanced surgical planning due to detailed anatomical and functional information
• Reduction in the need for exploratory surgery

Recovery

• Patients can typically resume normal activities immediately after the procedure.
• Drink plenty of fluids to help flush the radiopharmaceutical from your body.
• Follow any specific post-procedure instructions given by your healthcare provider.

Alternatives

• Ultrasound imaging of the neck
• 4D CT scans
• MRI of the neck
• Surgical exploration without preoperative imaging Each alternative has its own benefits and limitations in terms of accuracy, invasiveness, and availability.

Patient Experience

Patients might feel a slight pinch when the radiopharmaceutical is injected. During the scan, they need to lie still, which can sometimes be uncomfortable but is generally not painful. Adequate measures are taken to ensure patient comfort and minimize any anxiety or discomfort. Pain management typically isn't necessary as the procedure is non-invasive.