Mechanism of technetium 99m sestamibi parathyroid imaging and the possible role of p-glycoprotein

Surgery
B K MitchellB K Kinder

Abstract

Localization of parathyroid glands is critical in the treatment of recurrent or persistent hyperparathyroidism. Technetium sestamibi imaging may improve localization; however, the mechanism of visualization of parathyroid tissue remains unclear. On the basis of the chemical structure of sestamibi it has been suggested that p-glycoprotein is involved in the transport of sestamibi across cell membranes. This study was designed to examine sestamibi uptake and retention and p-glycoprotein expression in normal and abnormal parathyroid tissue. Thirty-two consecutive patients underwent 2-methoxy-isobutyl-isonitrile imaging immediately before parathyroid exploration. Tissue was obtained from normal and abnormal parathyroids and from the thyroid gland. Touch preparations gave rapid confirmation of tissue origin. Specimens were trimmed and weighed, and gamma-emission was counted. Percentage injected dose per gram of tissue was calculated. Immunohistochemistry was obtained with a battery of monoclonal antibodies to identify p-glycoprotein in parathyroid tissue submitted for permanent histologic examination. Slides were graded by a pathologist familiar with immunohistochemistry. Abnormal parathyroid tissue had a higher mean retention of in...Continue Reading

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Citations

Jan 6, 1999·The British Journal of Surgery·F PattouC Proye
Oct 9, 1999·The Australian and New Zealand Journal of Surgery·H TakamiA Kubo
Jan 22, 2005·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·N R Caron, O H Clark
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Oct 22, 2003·Archives of Pathology & Laboratory Medicine·Alexis Byrne Carter, Peter J Howanitz
Nov 15, 2003·Current Problems in Surgery·Julia A Sosa, Robert Udelsman

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