Radionuclide Imaging of the Parathyroid Glands

Palestro, Christopher J.; Tomas, Maria B.; Tronco, Gene

doi:10.1053/j.semnuclmed.2005.06.001

Cited by 211 publications

(171 citation statements)

References 22 publications

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“…This may be due to the high incidence of concomitant multinodular goiters in patients with primary hyperparathyroidism [18], especially in post-menopausal women [19]. Considering that some parathyroid lesions do not retain MIBI, whereas some thyroid gland nodules do retain MIBI [20], selection of patients that will benefit from other imaging modalities, such as SPECT/CT or dual isotope methods, may be beneficial in reducing medical costs.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Hwang

Rhee

Yun

et al. 2016

Nucl Med Mol Imaging

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Purpose Parathyroid adenoma detection with dual-phase 99m Tc-sestamibi (MIBI) scintigraphy depends on differential MIBI washout from thyroid. However, autoimmune thyroid disease (AITD) may cause MIBI to be retained in the thyroid gland and reduce parathyroid detection. We evaluated the impact of AITD on MIBI thyroid retention and additional benefit of SPECT/CT in these patients. Methods Dual phase planar MIBI and SPECT/CT was performed on 82 patients. SPECT/CT was performed immediately after delayed planar scan. Thyroid density (Hounsfield unit, CT-HU) and size were measured on CT component of SPECT/CT. MIBI uptake in early scans and retention in delayed scans were visually graded and correlated with clinical factors and CT findings. Finally, planar and SPECT/CT findings were compared for parathyroid lesion visualization according to thyroid MIBI retention. Results In early scan, multivariate analysis showed only thyroid size predicted early uptake. In delayed scan, multivariate analysis showed higher visual grade in early scan, lower CT-HU or AITD were significant predictors for delayed thyroid parenchymal retention. Overall, ten more parathyroid lesions were visualized on SPECT/CT compared to planar scans (57 vs. 47, p = 0.002). SPECT/CT was especially more useful in patients with thyroidal MIBI retention, as eight out of the ten additional lesions detected were found in patients with thyroid MIBI retention. Conclusion AITD is an important factor for MIBI thyroid parenchymal retention on delayed scans, and may impede parathyroid lesion detection. Patients with MIBI retention in the thyroid parenchyma on delayed scans are likely to benefit from an additional SPECT/CT.

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Section: Discussionmentioning

confidence: 99%

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Hwang

Rhee

Yun

et al. 2016

Nucl Med Mol Imaging

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“…It has been attributed to increased expression of P-glycoprotein or multidrug resistance related protein, which prevents the accumulation of MIBI even by the abnormally functioning glands. 26 Studies have shown previously that USG have good sensitivity than MIBI scan in picking up multiple hyper plastic parathyroid glands (75% versus 66%), however the combination of USG and MIBI scan have improved the sensitivity to 88%. 25 Some studies have shown that MIBI scan is better choice than USG in detecting ectopic parathyroid adenoma.…”

Section: Discussionmentioning

confidence: 99%

Prospective comparison of high resolution ultrasonography with technetium sestamibi scintigraphy and operative findings in detection of abnormally hyper functioning parathyroid gland/glands in primary hyperparathyroidism

Dar

Wani

et al. 2016

Int Surg J

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Background:Ultrasonography is cheap, easily available and convenient modality of diagnosis.Methods: We prospectively studied 61 patients with PHPT. Patients preoperatively underwent USG neck and MIBI scan, results were interpreted independently and compaired with intra operative findings.Results:61 patients who underwent parathyroidectomy for PHPT were studied. Ultrasonography neck showed correct side in 46/51 (90%) and correct site in 32/51 (63%) patients with single parathyroid adenomas. MIBI scan showed correct side and site of parathyroid adenoma in 46/50 (92%) and 43/50 (86%) patients respectively. Patients with double adenomas USG neck showed positive results in all 5 patient with 100% sensitivity where as MIBI scan showed positive results in four out of five patients (80%). 1 patient with four gland hyperplasia USG picked three out of four enlarged glands while as MIBI scan not picked any of the enlarged glands. Operative findings revealed that right lower parathyroid gland was the most common gland involved (54%) followed by left lower (29%), right upper (6.6%), left upper (0%) and multiple / bilateral (9.6%).Conclusions:USG is an affordable, conventional and useful tool in detecting enlarged parathyroid glands in most of the patients with PHPT, but operator dependant. However, when USG can’t detect enlarged parathyroid gland 99mTc-MIBI Scan is complimentary to it.

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“…Most false-negative results are due to small lesion size. Another reason may be related to cellular function [19]. Parathyroid tissue expressing P-glycoprotein or multi-drug resistance related protein (MRP) does not accumulate MIBI [20].…”

Section: Discussionmentioning

confidence: 99%

A Rare Co-Occurrence of Parathyroid and Papillary Thyroid Carcinoma

2016

ARC Journal of Clinical Case Reports

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Radionuclide Imaging of the Parathyroid Glands

Cited by 211 publications

References 22 publications

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Usefulness of SPECT/CT in Parathyroid Lesion Detection in Patients with Thyroid Parenchymal 99mTc-Sestamibi Retention

Prospective comparison of high resolution ultrasonography with technetium sestamibi scintigraphy and operative findings in detection of abnormally hyper functioning parathyroid gland/glands in primary hyperparathyroidism

A Rare Co-Occurrence of Parathyroid and Papillary Thyroid Carcinoma

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