Relation between Tc-99m sestamibi uptake and biological factors in hyperparathyroidism

Abstract

The results of our study show that the optimal imaging times after intravenous injection of MIBI are 15 minutes and 1 hour because of the shorter examination time without loss of diagnostic ability. In the present study, there was no significant correlation between MIBI uptake ratios and increased gland volume, or serum Ca and i-PTH levels. Besides, we think that oxyphil cell content may not have a main effect on MIBI uptake and retention. The fact of an adverse relation between phosphorus and MIBI retention in our study suggests that phosphorus level should be considered prior to MIBI imaging.

Preoperative Localization of Parathyroid Adenomas with Technetium-99m Methoxyisobutylisonitrile Imaging: Relationship with P-Glycoprotein Expression, Oxyphilic Cell Content, and Tumoral Tissue Volume

“…Besides this, in a study by Çermik et al, it has been reported that there is no significant correlation between MIBI uptake and gland volume and increased serum PTH level in patients with a big-sized parathyroid lesion. 23 Also in our study, we found similar results to the study of Çermik et al There was no statistically significant correlation between MIBI results and tumoral tissue volume (r ϭ Ϫ0.14; p ϭ 0.38) and serum PTH values (r ϭ Ϫ0.05; p ϭ 0.74) in this study. And also, we could not found significant correlation between MIBI results and serum Ca values (r ϭ Ϫ0.20, p ϭ 0.23).…”

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

“…Previous evidence is inconclusive, as some studies noted an association between sestamibi uptake and high serum level of PTH 9 and calcium 20 , whereas others found no relationship 10,19 . There is little consensus on the explanation for this weak association, although it has been suggested that calcium may play a role in modifying sestamibi kinetics by altering the membrane potential 21 .…”

“…Tumour volume was calculated according to the formula for ellipsoid volume (V) 9,10 , where V = π/6 × width × length × depth. Tumours smaller than 0·5 cm 3 were considered to be small.…”

“…However, false-negative results have been reported for large glands and very small adenomas may be detectable, indicating that size is not the only important factor 8,9 . Other factors said to influence sestamibi uptake include serum levels of calcium, parathyroid hormone (PTH) and phosphorus, and the predominant cell type (for example oxyphil content) 9,10 .…”

Association of Histological Findings with Tc-99m Sestamibi Parathyroid Imaging in Hyperfunctional Parathyroid Gland

“…A ratio of oxyphil to clear cells of more than 1 was correlated with positive scan 8 . As because clear cells have no known function and no significant metabolic activity, a review of several literatures showed large clear cell adenoma have little sestamibi uptake compare to oxyphil cell [9][10] . Same finding is shared by Carpentier et al 11 who reported that a higher oxyphil content (>25 %) was associated with an increased late technetium uptake.…”