James Norman, MD, FACS, FACE
(Single Proton Emission Computerized Tomography) scanning is a technique whereby
images can be obtained of diseased parathyroid glands which have absorbed a radioactive marker.
SPECT scanning is nothing more than a variant of Sestamibi Scanning for parathyroid glands.
The difference between SPECT Scanning for
parathyroids and and routine Sestamibi scanning for parathyroids
is nothing more than a different x-ray camera is used and many
more pictures are taken. Its the same dye put into the
patient's veins, and it works by the exact same principle. As a
general rule, it is LESS effective and LESS accurate.
We do not use SPECT! It is not as good!
doctors believe that SPECT scanning for parathyroid disease enables them
to increase the accuracy of routine Sestamibi scanning by about 2 to 3 percent.
SPECT scanning can be performed at any time within the first several hours after a
patient is injected with the radioactive Sestamibi radiopharmaceutical. During the scan,
30 (typical) or more images are taken surrounding the patient's head and neck. These images
can be viewed separately, or they can be assimilated to provide a three dimensional picture
as seen in the video accompanying this page. The most important
use for SPECT scanning is when ordinary Sestamibi scans are inconclusive or when
a more detailed anatomic localization is necessary such as when patients are being
re-operated on. We strongly believe that SPECT scans should only be done for
patients who have a tumor located in the chest. Some believe that the SPECT scanning to localize parathyroid glands
is a bit over used, and have suggested that it will be less necessary as hospitals become more
experienced with the routine sestamibi scan.
Update from Dr Norman, February 2011.
It is my firm belief that SPECT scanning is the worst thing that has
ever happened to patients with hyperparathyroidism. Radiologists have
found that insurance companies will pay more for this test than they will
for a regular Sestamibi scan, so SPECT scanning has become the most common
type of Sestamibi scan (SPECT scanning is a type of Sestamibi scanning).
SPECT scans have become garbage over the past 5-6 years with 99% of the
SPECT scans we see not worth the plastic they are printed on. We firmly
believe that SPECT scans are worthless. To illustrate this point, we will
not look at a SPECT scan that a patient underwent prior to coming to our
parathyroid center. Said differently, if one of our patients had a SPECT
scan performed, we will not waste 2 seconds to look at it. SPECT scans are
worthless, and the public is being scammed. If your surgeon says he knows
where your parathyroid tumor is located because you had a SPECT scan, you
must know that there is at least a 50% chance that this is wrong
Starting around 2006 some radiologists started combining SPECT scanning
with CAT scans, fusing the two scans together. Some call this a
"fusion" scan, others call this a 4-D CT scan, others simply
call it a SPECT-CT scan. We call it garbage and will not look at it.
These are games being played by inexperienced surgeons (or surgeons who
have little faith in being able to perform the parathyroid operation
successfully). They are trying to get a better idea where the parathyroid
tumor is located before they operate. Typically, they won't operate if the
scan isn't positive (remember I told you that the positive reading is
wrong about 50% of the time).
Almost 20% of our practice is comprised of operating on people who had
one or more unsuccessful parathyroid operations. We average about 2 of
these operations EVERY DAY. Without exception, these people were
operated on by a surgeon with little experience who believed he/she could
do the operation since they had a SPECT-CT scan that told them where the
parathyroid tumor was. They were wrong. The scan was wrong. Look
folks, you need a good surgeon, not your local surgeon who thinks he can
do this because he has a magical scan. We wish nobody had to come to us
with a big scar on their neck without a voice. We're tired of seeing this!
Suggested Next Readings:
|If you have not read about Sestamibi
Scanning to find the bad parathyroid gland, then please do so by clicking
here. The Sestamibi scan is of central importance to the care of
patients with parathyroid disease.|
|Read how the radioactive parathyroid gland can be found in the
operating room by the surgeon using a radioactive probe (this is the MIRP
This page was last updated: Saturday, June 08, 2013