Clinical value of 99mTc-MIBI scintigraphy in patients with secondary hyperparathyroidism. A systematic review and meta-analysis of observational studies in Japan

DOI Web Site 24 References
  • Wakasugi Minako
    Center for the Inter-organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences
  • Kazama Junichiro James
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
  • Narita Ichiei
    Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences

Bibliographic Information

Other Title
  • ｀９９ｍ´Ｔｃ－ＭＩＢＩシンチグラフィの有用性　　‐システマティックレビューおよびメタアナリシス‐
  • 99mTc-MIBIシンチグラフィの有用性--システマティックレビューおよびメタアナリシス
  • 99mTc MIBI シンチグラフィ ノ ユウヨウセイ システマティックレビュー オヨビ メタアナリシス
  • ―システマティックレビューおよびメタアナリシス―

Search this article

Abstract

【Background】 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) has been widely used for parathyroid scintigraphy to detect enlarged parathyroid glands prior to parathyroidectomy in Japan. Public health insurance in Japan, however, did not cover 99mTc-MIBI. There is currently no reliable randomized evidence that 99mTc-MIBI is more effective than 201TlCl. 【Objectives】 This study evaluated the diagnostic accuracy of 99mTc-MIBI in detecting parathyroid glands among secondary hyperparathyroidism patients in Japan. 【Study Design】 Systematic review and meta-analysis. 【Data sources】 PubMed,“I-Chuu-Shi Web”, and reference screening of data between January 1983 and December 2009. 【Study Selection】 All randomized trials, cohort studies, case-control studies, and case series were considered if they used 99mTc-MIBI to detect parathyroid glands as preoperative examination prior to parathyroidectomy among secondary hyperparathyroidism patients in Japan. 【Data appraisal and synthesis methods】 One reviewer (M.W.) assessed quality and extracted data, baseline characteristics, and outcomes of interest (sensitivity of 99mTc-MIBI). We presented true positive, false negative, and pooled estimate of sensitivity. We refrained from pooling when there was considerable clinical or statistical heterogeneity. 【Results】 Eight case series (n=96 patients) were included. There were no significant differences in sensitivity of 99mTc-MIBI. The pooled sensitivity of 8 studies was 72% (95% confidence interval=67 to 77%). 【Discussion】 The sensitivity of 99mTc-MIBI in Japan seems to be higher than that reported in the previous international systematic review. It is well known that sensitivities vary not only across different populations but also across different subgroups within particular populations. Different clinical guidelines for parathyroidectomy among patients with secondary hyperparathyroidism may affect these sensitivities. 【Conclusions】 99mTc-MIBI is effective in detecting parathyroid glands among secondary hyperparathyroidism patients in Japan. However, observational studies are not shielded from other biases that could affect results.

Journal

References(24)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top