The diagnostic utility of dual phase Tc-99m sestamibi parathyroid imaging

Clinical Nuclear Medicine
P Klieger, R O'Mara

Abstract

Primary hyperparathyroidism is a disease of uncertain etiology that results from hypersecretion of parathyroid hormone (PTH) by the parathyroid gland. In most institutions, the preferred imaging protocol utilizes a dual-phase technique with Tc-99m sestamibi which is reported to be more sensitive than earlier protocols involving TI-201 with Tc-99m pertechnetate subtraction. The purpose of this study is to evaluate the accuracy and clinical utility of Tc-99m sestamibi dual-phase scintigraphy for localizing hyperfunctioning parathyroid tissue. We retrospectively reviewed thirty-nine consecutive hyperparathyroid patients who received a dual-phase Tc-99m sestamibi parathyroid scan. Thirty-seven of the subjects subsequently underwent a bilateral neck exploration and parathyroidectomy. Each scan interpretation was then correlated with the histopathologic diagnosis and the patients' post-surgical clinical course. The sestamibi dual-phase imaging protocol correctly localized 21 of 25 parathyroid adenomas and identified 8 out of 10 cases of hyperplasia. Our overall sensitivity and specificity were 83% and 75%, respectively. In addition, four of the adenomas were successfully localized intraoperatively using a gamma probe. Parathyroid ima...Continue Reading

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May 1, 2004·Joint, Bone, Spine : Revue Du Rhumatisme·David MalinvaudRémi Marianowski
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