Purpose: To evaluate the accuracy of technetium-99m sestamibi as a single agent in the detection and localization of hyperfunctioning parathyroid tissue in patients who underwent prior neck exploration or who otherwise are high surgical risks.
Materials And Methods: Thirty-nine patients with hyperparathyroidism underwent 40 double-phase Tc-99m sestamibi studies. Histopathologic correlation was obtained for all studies.
Results: Thirty patients had solitary adenomas, and nine had hyperplastic glands. One developed recurrent hypercalcemia after five-gland resection and underwent repeat imaging and operation. Double-phase sestamibi imaging prospectively enabled localization of 46 (77%) of 60 abnormal glands. Twenty-eight (93%) of 30 adenomas were correctly localized, whereas 18 (60%) of 30 hyperplastic glands were localized. The overall specificity of the study was 98% with one false-positive study. Gland weight and vascularity were statistically significant predictors of uptake of sestamibi.
Conclusion: Double-phase Tc-99m sestamibi imaging is a promising technique for localization of parathyroid adenomas in high-risk surgical patients. Localization of multiple hyperplastic glands remains a challenge.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1148/radiology.197.3.7480730 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Primary Hyperparathyroidism: A Common Condition With an Uncommon Location.
Cureus
December 2024
Endocrinology Department, Hospital de Egas Moniz - Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT.
Primary hyperparathyroidism (PHPT) is a prevalent clinical condition characterized by an inappropriate secretion of parathyroid hormone (PTH). It is most often caused by one or more parathyroid adenomas, which can, in rare cases, be ectopically located. Ectopic adenomas can pose a diagnostic challenge, lead to treatment delay, and be a common cause of recurrent hypercalcemia after parathyroidectomy.
View Article and Find Full Text PDFCase report: Prolonged and severe hungry bone syndrome after parathyroidectomy in X-linked hypophosphatemia.
Front Endocrinol (Lausanne)
January 2025
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
Tertiary hyperparathyroidism is characterized by hypercalcemia resulting from autonomous parathyroid hormone production and usually occurs after a prolonged period of secondary hyperparathyroidism. This condition can be a complication of X-linked hypophosphatemia (XLH), a rare genetic disease characterized by renal phosphate loss and consequent hypophosphatemia. Parathyroidectomy is considered the first-line therapy but surgical intervention can be complicated by hungry bone syndrome.
View Article and Find Full Text PDFHow has the diagnostic approach to parathyroid localization techniques evolved in the past decade? Insights from a single-center experience.
Updates Surg
January 2025
Division of General Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
The standardization of preoperative imaging in primary hyperparathyroidism is one of the current challenges of endocrine surgery. A correct localization of the hypersecretory gland by neck ultrasound and 99mTc-sestamibi (MIBI) scintigraphy are not sufficiently sensitive in some cases. In recent years, CT-4D, 18F-Fluorocholine PET/CT, and radio-guided parathyroidectomy have come into common use.
View Article and Find Full Text PDFChapter 10: WHAT PARATHYROID IMAGING IS REQUIRED FOR HYPERPARATHYROIDISM?
Ann Endocrinol (Paris)
January 2025
Endocrinology Federation, Hôpital Louis Pradel, 28 Avenue doyen Lépine, 69500 Bron, Hospices Civils de Lyon and Université Lyon 1, France. Electronic address:
In over 80% of cases, primary hyperparathyroidism results from hypersecretion of PTH by a single parathyroid adenoma. Multi-glandular involvement, combining adenoma and/or hyperplasia in varying proportions, is also possible, although less frequent. When the diagnosis of hyperparathyroidism is certain and surgery is envisaged, imaging is useful for locating the hyperfunctioning gland or glands.
View Article and Find Full Text PDFDiagnostic accuracy of low-dose myocardial perfusion imaging in a real-world setting.
J Nucl Cardiol
January 2025
Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, F-54000, France; Université de Lorraine, INSERM U1254, IADI, Nancy, F-54000, France. Electronic address:
Background: This large-scale study analyzes factors affecting the diagnostic accuracy of low-dose myocardial perfusion imaging and correlation with coronary angiography in a real-world practice.
Methods: We compared data extracted from routine reports of (i) low-dose [Tc]sestamibi stress-MPI performed with no attenuation correction and predominantly exercise stress testing and (ii) the corresponding coronary angiography.
Results: We considered 1070 pairs of coronary angiography/stress-MPI results reported by 11 physicians.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!