- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00639405
Evaluation of MRI and SPECT Fusion Software to Localize Parathyroid Adenomas
Localization of Parathyroid Adenomas Using MRI and SPECT Fusion Software in Patients With Persistent or Recurrent Hyperparathyroidism
Studieoversigt
Status
Betingelser
Detaljeret beskrivelse
While a successful neck exploration for PHP is primarily dependent on the experience of the surgeon, there are currently several localizing studies available to increase success. Although the necessity of localizing studies pre-operatively for first time neck explorations is still under debate, there is no question of their importance for persistent or recurrent PHP that requires re-operation. Localizing studies in these patients have been clearly shown to reduce operating time, avoid unnecessary dissection, reduce morbidity, and improve success rate.
Several modalities have been employed for localization such as ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The sensitivity of ultrasound for the preoperative detection of parathyroid adenomas has been reported to be 65-90% (1). There are however, limitations to US. Because of the sonolucent appearance of parathyroid adenomas, it is impossible to distinguish an ectopic cervical parathyroid adenoma from a pathologic lymph node. Furthermore, mediastinal parathyroid adenomas are difficult, if not impossible to visualize due to acoustic shadowing from the sternum and clavicles (2). Also, this method is very operator-dependent. MRI has a slightly higher sensitivity of 62.5-94% while CT has a poor sensitivity of only 40-44% (1).
We are using dual-phase single photon emission tomography (SPECT) imaging with technetium 99m sestamibi and visual thyroid subtraction with technetium 99m as pertechnetate. This method can achieve sensitivities of 68-95% and specificities of 75-100% (1). SPECT imaging is dependent on the differential washout of sestamibi between normal thyroid tissue and abnormal parathyroid tissue. Theoretically, sestamibi will washout of normal thyroid tissue much more quickly than it will from abnormal parathyroid tissue. Therefore, SPECT imaging is usually performed immediately and then at 90 and 180 minutes after sestamibi injection. SPECT imaging, however, has several limitations, not the least of which is its inability to provide discrete anatomic detail.
In addition, we will use a control group of patients who have parathyroid adenomas but who have not yet had surgery to test the efficacy of our fusion software.
Our goal is to acquire MRI and SPECT imaging with fiducial markers and utilize fusion software to create a detailed anatomic map of the neck for more accurate localization of the lesion.
Undersøgelsestype
Tilmelding (Faktiske)
Kontakter og lokationer
Studiesteder
-
-
New York
-
Syracuse, New York, Forenede Stater, 13210
- SUNY Upstate Medical University
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Subjects who are 18 years and over
- subjects who have had a failed parathyroidectomy and now presents with persistent hyperparathyroidism or recurrent hyperparathyroidism
- 6 control patients with parathyroid adenomas who have not yet had surgery will be selected to test the efficacy of the software.
Exclusion Criteria:
- Potential female subjects who are pregnant
- Any potential subject who has an implanted metallic device, stent or staples
- any subject weighing 300lb
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Observationsmodeller: Kun etui
- Tidsperspektiver: Fremadrettet
Kohorter og interventioner
Gruppe / kohorte |
---|
1
subjects who are diagnosed with parathyroid adenomas.
There will be 6 subjects who have not had surgery and 25 subjects who have had surgery.
|
Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Michele Lisi, MD, State University of New York - Upstate Medical University
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- SUNYUMU 5260
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Parathyreoidea sygdomme
-
M.D. Anderson Cancer CenterAfsluttetParathyroid karcinom | Parathyroid neoplasmaForenede Stater
-
David M. Schuster, MDAfsluttet
-
Oxford University Hospitals NHS TrustTheraclionAfsluttetParathyroid adenomerDet Forenede Kongerige
-
Hospital General Ajusco MedioInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranAfsluttetHyperparathyroidisme | Mediastinalt parathyroid adenom
-
Tongji HospitalUkendtParathyroid autolog transplantationKina
-
Erhan AysanAfsluttet
-
TheraclionAfsluttetPrimære parathyroid adenomerFrankrig
-
University of East AngliaMinistry of Defence, United Kingdom; Clinical Research and Trials Unit... og andre samarbejdspartnereUkendtStressfraktur | Parathyroid hormonDet Forenede Kongerige
-
Fujian Medical UniversityAfsluttetIntraoperativt parathyroid scoresystemKina
-
Peter VestergaardAalborg UniversityAfsluttetPrimær hyperparathyroidisme | Parathyroid adenom | Parathyroid hyperplasiDanmark