Localization of abnormal parathyroid glands of the mediastinum with MR imaging.

Kang, Yusuhn; Rosen, Kenneth M.; Clark, O H; Higgins, C B

doi:10.1148/radiology.189.1.8372183

Cited by 53 publications

(14 citation statements)

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“…While ultrasonography cannot detect ectopic parathyroid glands, the radionuclide technique can localize these glands [23]. MR imaging has been widely utilized and it may reduce the number of missed lesions [4]. However, a disadvantage of MR imaging is that some ectopic glands may be located in regions outside a neck coil.…”

Section: Discussionmentioning

confidence: 99%

“…Imaging techniques to localize abnormal parathyroid glands include ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging, and Tl-201/Tc-99m pertechnetate (Tl/Tc), or Tl-201/I-123 subtraction imaging [1, 2, 3, 4]. In 1989, a new approach utilizing the myocardial imaging radiopharmaceutical Tc-99m sestamibi [5] was reported [6].…”

Section: Introductionmentioning

confidence: 99%

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Localization of Parathyroid Glands in Hemodialysis Patients Using Tc-99m Sestamibi Imaging

Ishibashi

Nishida²,

Okuda³

et al. 1997

Nephron

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Tc-99m sestamibi parathyroid imaging was performed in 28 patients with chronic renal failure to localize abnormal parathyroid glands in patients receiving hemodialysis, and compared the localization with ultrasonography and magnetic resonance (MR) imaging. Methods: We imaged 28 patients with secondary hyperparathyroidism using Tc-99m sestamibi (about 600 MBq) at 10 min and 2–3 h following radiotracer injection. In addition, mediastinal images were recorded at approximately 1 h following injection to identify ectopic parathyroid glands. All patients also were evaluated with ultrasonography and MR imaging. Results: Tc-99m sestamibi scans demonstrated focal uptake in 60 glands of the 28 patients, and was categorized as slight uptake in 71.7% (43/60), and intense uptake in 28.3% (17/60). Seventeen of the 28 patients underwent parathyroidectomy. A total of 64 glands were resected. Sestamibi imaging was more sensitive for localizing abnormal parathyroid glands than ultrasonography or MR imaging. Histologic evaluation of 27 resected parathyroid glands revealed that the number of oxyphil or chief cells was not proportional to sestamibi uptake. Conclusion: Our data indicate that Tc-99m sestamibi imaging should be used initially to localize abnormal parathyroid glands in hemodialysis patients with secondary hyperparathyroidism, prior to MR imaging or ultrasonography. Sestamibi uptake in parathyroid glands may not correlate with the degree of hypercellularity of oxyphil cells.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Localization of Parathyroid Glands in Hemodialysis Patients Using Tc-99m Sestamibi Imaging

Ishibashi

Nishida²,

Okuda³

et al. 1997

Nephron

View full text Add to dashboard Cite

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“…Preoperative imaging techniques include ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and Tl-201/Tc-99m pertechnetate (Tl/Tc) or Tl-201/I-123 subtraction scintigraphy [3][4][5][6][7][8]. In 1989, a new approach utilizing myocardial imaging with radiopharmaceutical Tc-99m sestamibi (MIBI) was reported for the localization of parathyroid glands of the normoxic and ectopic regions [9,10].…”

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confidence: 99%

Comparison of Histological Findings and Parathyroid Scintigraphy in Hemodialysis Patients with Secondary Hyperparathyroid Glands

et al. 2005

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Abstract. To determine the usefulness of parathyroid scintigraphy in histological estimation for secondary hyperparathyroidism (2HPT) using Tc-99m sestamibi or Tc-99m tetrofosmin. Tc-99m sestamibi (MIBI) and Tc-99m tetrofosmin (Tetro) parathyroid imaging following double-phase study, magnetic resonance imaging (MRI), and ultrasound were performed on 14 patients with 2HPT. All patients underwent parathyroidectomy. The uptake of two tracers in parathyroid areas was compared with the histopathologic findings. Forty-nine parathyroid glands were surgically explored and histologically proven to be hyperplastic. Of these, 42 were diagnosed with nodular type (N-type) hyperplasia, and 7 with diffuse type (D-type) hyperplasia. MIBI and Tetro parathyroid imagings detected 34 and 35 parathyroid glands, respectively. The sensitivity of MIBI was determined to be 76.2% (32/42) for N-type, and 28.6% (2/7) for D-type. The sensitivity of Tetro was determined to be 78.6% (33/42) for N-type and 28.6% (2/7) for D-type. The sensitivity of both MIBI and Tetro was significantly higher for N-type than for D-type, 76.2% (32/42) vs. 28.6% (2/7) in MIBI, P = 0.022; 78.6% (33/42) vs. 28.6% (2/7) in Tetro, P = 0.015. The sensitivity of MRI was determined to be 76.2% (32/42) for N-type and 42.9% (3/7) for D-type, and the sensitivity of ultrasound was 71.4% (30/42) for N-type and 71.4% (5/7) for D-type. There was no significant difference in the sensitivity of MRI or ultrasound between N-type and D-type. The uptake ratios of MIBI and Tetro were also greater for N-type than for D-type. The detectability of both MIBI and Tetro was greater for N-type than for D-type. Tc-99m MIBI or Tc-99m Tetro parathyroid scintigraphy therefore may be used clinically to distinguish N-type from D-type parathyroid gland hyperplasia.

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“…1,17 For planer Tc-99m MIBI scan the sensitivity was 77%-85% for all locations and 58%-67% for the mediastinum. 1,10,16,17 The combination of the planer Tc-99m MIBI scan and MRI reaches a sensitivity of 92%-94%, whereas combining either of these tests with US did not improve the sensitivity of either test alone. 17,18 In all ectopic parathyroid tumors, the specificity of planer Tc-99m MIBI scan was 88%, of MRI 88% and of CT 88%.…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivity for US ranges from 45%-57% for all locations and 12%-18% for the mediastinum. 1,10,15,16 For CT the sensitivity ranges from 42%-68% for all locations, while it was 57% for the mediastinum. 1,10,15 The MRI sensitivity was 77%-82% for all locations and 88% for the mediastinum.…”

Section: Discussionmentioning

confidence: 99%

Supernumerary ectopic parathyroid glands. Persistent hyperparathyroidism due to mediastinal parathyroid adenoma localized by preoperative single photon emission computed tomography and intraoperative gamma probe application

Uludağ¹,

İşgör²,

Yetkin³

et al. 2009

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Ectopic and/or supernumerary parathyroid glands are a major cause of persistent and recurrent Hyperparathyroidism (HPT). For this reason, it is widely accepted that preoperative localization should be performed to improve the surgical results in patients with persistent or recurrent HPT. Primary HPT (pHPT) was diagnosed incidentally in a 50-year old female patient during a preoperative examination for hernia. No pathologic parathyroid gland was detected in the preoperative Tc-99m Methoxybutylisonitrile (MIBI) scintigraphy and Ultrasonography (US). Cervical exploration was performed bilaterally. Four parathyroid glands were located adjacent to the thyroid gland. A fifth was detected in front of the cricoid cartilage. All five of them were of normal histology. Postoperatively, hypercalcemia persisted. Single Photon Emission Computed Tomography (SPECT) was performed before the second operation and radioguide surgery was carried out by median sternotomy. SPECT showed a parathyroid adenoma in the middle of the anterior mediastinum which was excised (size 1x0.5x0.5 cm) using a gamma probe. In conclusion, SPECT and intraoperative gamma probe application may help to detect the parathyroid adenomas, especially if they are small in size and buried in the adipose tissue. Such localization shortens the duration of the operation and reduces the possibility of complications.

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Localization of abnormal parathyroid glands of the mediastinum with MR imaging.

Abstract: MR imaging should be considered the modality of choice for preoperative localization in this group of patients.

Cited by 53 publications

References 0 publications

Localization of Parathyroid Glands in Hemodialysis Patients Using Tc-99m Sestamibi Imaging

Localization of Parathyroid Glands in Hemodialysis Patients Using Tc-99m Sestamibi Imaging

Comparison of Histological Findings and Parathyroid Scintigraphy in Hemodialysis Patients with Secondary Hyperparathyroid Glands

Supernumerary ectopic parathyroid glands. Persistent hyperparathyroidism due to mediastinal parathyroid adenoma localized by preoperative single photon emission computed tomography and intraoperative gamma probe application

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