Sestamibi Scintigraphy, Topography, and Histopathology of Parathyroid Glands in Secondary Hyperparathyroidism

Lomonte, Carlo; Buonvino, Nicola; Selvaggiolo, Michele; Dassira, Mario; Grasso, Giovanni; Vernaglione, Luigi; Basile, Carlo

doi:10.1053/j.ajkd.2006.06.010

Cited by 22 publications

(7 citation statements)

References 22 publications

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“…We found that the superior PGs tended to have a lighter weight, smaller volume, lower PCNA expression, and lower degree of hyperplasia. Our preoperative 99m Tc-MIBI imaging showed that the degree of visualization of the superior PGs was lower, consistent with previous research (33). This may be due to the effect of hemodynamics, gravity, and a relatively narrow growth area, leading to slower pathological growth in the superior PGs than in the inferior PGs (32).…”

Section: Discussionsupporting

confidence: 89%

Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Yang

Chen

et al. 2021

Quant Imaging Med Surg

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Background: Previous studies have demonstrated that 99m Tc-sestamibi ( 99m Tc-MIBI) Single-Photon Emission Computed Tomography/ Computed Tomography (SPECT/CT) imaging is an effective isotopic technique for locating the parathyroid in secondary hyperparathyroidism (SHPT). This study aimed to explore further the correlation between 99m Tc-MIBI SPECT/CT imaging and SHPT to demonstrate the value of 99m Tc-MIBI SPECT/CT in evaluating the degree of pathological hyperplasia of the parathyroid gland (PG). Methods:The demographics, surgical records, and follow-up information of 91 patients were recorded and analyzed. A total of 216 paraffin-embedded PGs of 54 patients were obtained and analyzed.Results: Patients with 99m Tc-MIBI negative PG(s) had significantly lower preoperative serum phosphorus and higher serum calcium levels at 6 months postoperatively compared to those with 99m Tc-MIBI positive PG(s) (P<0.05). We also found a higher total uptake ratio of the region of interest (URRI) and higher URRI max in the hypocalcemia group than in the non-hypocalcemia group. Both URRI total (P=0.003) and URRI max (P=0.028) were independent risk factors for hypocalcemia 6 months postoperatively. The URRI values of the PGs were significantly positively correlated with glandular weight (R 2 =0.343, P<0.001), glandular volume (R 2 =0.240, P<0.001), and degree of pathological hyperplasia (P<0.001). However, the URRI value of the PGs exhibited a notably weak correlation with proliferating cell nuclear antigen (PCNA) (R 2 =0.035, P=0.006). The area under the receiver operating characteristic curve showed a URRI evaluative value of 0.771 for diffuse and nodular types in 216 PGs (P<0.001). We further evaluated 167 nodular-type PGs, distinguishing between nodular hyperplasia and a single nodule; the URRI evaluative value reached 0.819, which was higher than the volume or weight (P<0.001).Conclusions: The 99m Tc-MIBI SPECT/CT scintigraphy results were related to serum calcium levels at 6 months after total parathyroidectomy with autotransplantation (TPTX+AT), suggesting the occurrence of hypocalcemia (6 months after TPTX+AT). More importantly, this technique effectively evaluated the pathological hyperplasia of PGs preoperatively, and therefore, could assist surgeons in selecting the PGs with the lowest degree of hyperplasia intraoperatively.

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Section: Discussionsupporting

confidence: 89%

Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Yang

Chen

et al. 2021

Quant Imaging Med Surg

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“…Decreased sensitivity in multigland disease compared with single-gland disease is well recognized for planar and SPECT imaging. The study of Lomonte et al 40 aimed to evaluate the value of dual-phase 99m Tc-sestamibi scintigraphy in preoperative localization of the hyperplastic parathyroid glands in patients with secondary hyperparathyroidism. Their conclusions were that 99m Tc-sestamibi scintigraphy did not show high sensitivity in discovering hyperplastic glands, nevertheless it was of help to discriminate between patients with nodular and diffuse hyperplasia.…”

Section: Parathyroid Scintigraphy With 99m Tc -Sestamibimentioning

confidence: 99%

Nuclear Medicine Methods for Evaluation of Abnormal Parathyroid Glands in Patients with Primary and Secondary Hyperparathyroidism

Botushanova¹,

Botushanov²,

M³

2017

Folia Medica

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Considered rare disease in the past, primary hyperparathyroidism (PHPT) has dramatically increased in incidence over the past thirty years with the introduction of routine calcium measurements; it is now approximately 42 per 100 000 persons. By far, the most common lesion found in patients with PHPT is the solitary parathyroid adenoma, occurring in 85%-90% of patients, while in the rest 10%- 15% primary hyperplasia of the parathyroid glands is present. Currently, the most widely used surgical approach is minimally invasive parathyroidectomy which is associated with less post-surgery complications and shorter operation time. To be successful this procedure needs to rely on a precise preoperative localization of the abnormal parathyroid glands, hence preoperative parathyroid imaging gained so large importance. The rationale for locating abnormal parathyroid tissue prior to surgery is that the glands can be notoriously unpredictable in their location. There is a general consensus that the best imaging procedure identifying abnormal parathyroid glands is the preoperative scintigraphy with 99mTc-sestamibi or 99mTc-tetrofosmin. It is characterized with high sensitivity and specificity exceeding those of ultrasound, CT or MRI. Combining scintigraphy with the other imaging techniques increases the precision for topic localization.

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“…Myocardial cleaning is very slow and almost there is no redistibution after 3-4 h from the injection. It accumulates in the mitochondria of the cell (Lomonte et al, 2006). 99m Tc sestamibi diffuses passively out of the blood and apparently localizes in the mitochondria on the basis of their negative electrical potentials (Beller et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

Effects of ^99mTc sestamibi on antioxidant defense system and lipid peroxidation in the heart of Sprague Dawley rats

et al. 2012

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Nuclear medicine has been using radiopharmaceuticals for the diagnostic and therapeutic purposes of many diseases. Technetium-(99m) methoxyisobutylisonitrile ((99m)Tc sestamibi) is a lypophilic complex that has a positive-loaded isonitril group. Aim of the study is to investigate whether (99m)Tc sestamibi, which is one of the mostly used radiopharmaceuticals in nuclear medicine field, causes oxidative damage or not in rats' heart after an injection. A total of 16 male Sprague Dawley rats were randomly divided into two groups: group I: (99m)Tc sestamibi group, (99m)Tc sestamibi administered intravenously with the dose of 25MBq; group II: control group, one dose of isotonic sodium chloride was administered intravenous with the same volume as (99m)Tc sestamibi group. Malondialdehyde (MDA) and total oxidant status (TOS) were used as markers of oxidative stress-induced heart impairment. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and total antioxidant status (TAS) activities were studied to evaluate the changes in the antioxidant status. In the (99m)Tc sestamibi group (group I), animals treated with (99m)Tc sestamibi produced a significant decrease in the activities of antioxidant enzymes (SOD and CAT), while MDA level increased when compared with control group (group II) in myocardial tissue (p < 0.05). On the other hand, the GSH-Px activities were significantly increased in the (99m)Tc sestamibi-treated rats compared with the untreated rats (p < 0.05). There was no significant difference in the TAS and TOS levels of plasma.

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Sestamibi Scintigraphy, Topography, and Histopathology of Parathyroid Glands in Secondary Hyperparathyroidism

Cited by 22 publications

References 22 publications

Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Nuclear Medicine Methods for Evaluation of Abnormal Parathyroid Glands in Patients with Primary and Secondary Hyperparathyroidism

Effects of ^99mTc sestamibi on antioxidant defense system and lipid peroxidation in the heart of Sprague Dawley rats

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Sestamibi Scintigraphy, Topography, and Histopathology of Parathyroid Glands in Secondary Hyperparathyroidism

Cited by 22 publications

References 22 publications

Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Use of 99mTc-sestamibi SPECT/CT imaging in predicting the degree of pathological hyperplasia of the parathyroid gland: semi-quantitative analysis

Nuclear Medicine Methods for Evaluation of Abnormal Parathyroid Glands in Patients with Primary and Secondary Hyperparathyroidism

Effects of 99mTc sestamibi on antioxidant defense system and lipid peroxidation in the heart of Sprague Dawley rats

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Effects of ^99mTc sestamibi on antioxidant defense system and lipid peroxidation in the heart of Sprague Dawley rats