P-glycoprotein expression is associated with sestamibi washout in primary hyperparathyroidism

Abstract

These data suggest an association between P-gp membrane expression and false-negative sestamibi scan result. Inhibition of the P-gp transmembrane pump using MDR modulators may therefore improve the sensitivity of sestamibi scintigraphy.

Radio-guided parathyroidectomy in patients with primary hyperparathyroidism and concomitant multinodular goiter

“…30,31 There are, however, studies in which no preoperative proof of location was possible even though a large parathyroid adenoma was present. [32][33][34][35] It is currently unclear whether this observation is associated with adenomaspecifi c characteristics as proposed by Gupta et al 36 The current patient population showed no statistically relevant correlation between the proof of the adenoma and the size of the adenoma. This is probably due to the small sample size.…”

Parathyroid nuclear scan. A focused review on the technical and biological factors affecting its outcome

“…P-gp expression in parathyroid adenomas has been postulated to be another important factor influencing 99mTc-MIBI and Tc-TF uptake in parathyroid adenomas. In one study, 71% (10 of 14) of adenomas with strong P-gp membrane positivity had negative imaging and 70% (45 of 64) with negative P-gp membrane expression (p=0.006) had a positive scan (14). iv.…”

Análisis de falsos negativos en la cintigrafía SPECT de paratiroides con sestamibi en pacientes con hiperparatiroidismo primario sometidos a cirugía entre 2008-2015 en hospital universitario

“…Por el contrario, el carcinoma presentó el porcentaje más alto lo que indicaría que hay otros factores involucrados. Entre estos, la mayor expresión de P-gp en tumores malignos, impediría la acumulación del radiotrazador, determinando falsos negativos 9,10,18 . A pesar de su alta sensibilidad y especificidad, el SPECT está limitado por una baja resolución espacial e incapacidad para proporcionar detalles anatómicos.…”

“…La P-gp es una proteína de transmembrana codificada por el gen MDR. Las glándulas con mayor expresión no acumulan radiotrazador, produciendo falsos negativos 9,10 . Las células oxífilas, son ricas en mitocondrias por lo tanto, los tumores con mayor porcentaje de estas células tendrían una adecuada captación del sestamibi 11 .…”