Using technetium 99m tetrofosmin parathyroid imaging to detect parathyroid adenoma and its relation to P-glycoprotein expression

Wu, Hurng‐Sheng; Liu, Yao-chi; Kao, Albert; Wang, Jhi-Joung; Ho, Shung‐Tai

doi:10.1067/msy.2002.127551

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…Other studies have concluded that both a small adenoma size and p-gp expression may limit the sensitivity of sestamibi imaging to localize parathyroid adenomas preoperatively [14]. Similar results have been obtained from studies using tetrofosmin as a radionuclide tracer [15]. …”

Section: Discussionsupporting

confidence: 63%

Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

et al. 2014

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BackgroundTc-sestamibi is the most frequently used radionuclide agent for the detection of parathyroid adenomas in the clinical setting. However, Tc-tetrofosmin is another such agent that may be used for this purpose. This case report presents the significance and practicality of 99mTc-tetrofosmin for the diagnosis of parathyroid adenomas with probable high p-glycoprotein levels.Case presentationA 45-year-old woman was referred to our Nuclear Department with a palpable neck nodule suspicious for parathyroid adenoma. She had no significant medical history or other accompanying symptoms. Blood examination results were normal with the exception of the parathormone level which was high at 167.2 pg/ml. Neck ultrasonography revealed a hypoechoic mass near the lower pole of the thyroid gland. 99m Tc-tetrofosmin dual-phase scintigraphy with early and delayed images was performed and the results supported the presupposition of parathyroid adenoma as shown by increased radiopharmaceutical levels near the lower left thyroid gland on the early image that disappeared on the delayed image. Moreover, TcO4− thyroid scintigraphy results excluded thyroid pathology. Two months after the diagnosis, parathyroidectomy was successfully performed without postoperative complications. The pathology report and clinical response to a gradual decrease of parathormone confirmed the initial diagnosis.ConclusionWe strongly recommend the use of reverse 99m Tc-tetrofosmin scintigraphy as a useful and safe examination technique for the diagnosis of parathyroid adenomas.

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Section: Discussionsupporting

confidence: 63%

Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

et al. 2014

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“…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 .…”

Section: Discussionmentioning

confidence: 91%

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

Gupta

Ahmed

Happerfield

et al. 2007

British Journal of Surgery

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“…The intensity of nuclear stain was scored as 0, achromatic; 1, light yellow; 2, brownish yellow; or 3, brown. The degree of nuclear stain was scored as 1 when 0–25% of the nuclei were stained, 2 when 26–75% of the nuclei were stained, and 3 when 76% or more of the nuclei were stained 30 . Both parameters were summed to obtain a final score: less than or equal to 4 was considered a negative result and greater than or equal to 5 was considered a positive result.…”

Section: Methodsmentioning

confidence: 99%

Dual-phase 99mTc-MIBI imaging and the expressions of P-gp, GST-π, and MRP1 in hyperparathyroidism

Xue

Liu²,

Yang³

et al. 2017

Nuclear Medicine Communications

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ObjectiveThe aim of this study was to further elucidate the mechanisms of dual-phase technetium-99m methoxyisobutylisonitrile (99mTc-MIBI) parathyroid imaging by exploring the association between early uptake results (EUR), delayed uptake results (DUR), and the retention index (RI) in dual-phase 99mTc-MIBI parathyroid imaging and P glycoprotein (P-gp), multidrug resistance-associated protein 1 (MRP1), and glutathione S-transferase-π (GST-π) expression in hyperparathyroidism (HPT).Patients and methodsPreoperative dual-phase (early and delayed) 99mTc-MIBI imaging was performed on 74 patients undergoing parathyroidectomy for HPT. EUR, DUR, and RI were calculated. P-gp, MRP1, and GST-π expressions were assessed using immunohistochemistry in resected tissue from HPT and control patients. The association between P-gp, MRP1, and GST-π expressions and EUR, DUR, and RI in HPT was evaluated.ResultsThe positive rate of dual-phase 99mT c-MIBI imaging was 91.89% (68/74) and the false-negative rate was 8.11% (6/74). P-gp and GST-π expressions were higher in tissues resected from control compared with HPT patients (47.37 and 81.5%, P<0.05); there was no difference in MRP1. EUR were associated with P-gp and GST-π expressions, and DUR were associated with MRP1 expression. There was a significant difference in MRP1 expression between RI greater than or equal to 0 and RI less than 0. There was no relationship between the sensitivity of dual-phase 99mTc-MIBI imaging and P-gp, MRP1, and GST-π expressions in resected parathyroid tissue. The six false-negative HPT cases consisted of three P-gp (−)/MRP1 (−) tissues, three P-gp (−)/GST-π (−) tissues, and four MRP1 (−)/GST-π (−) tissues.ConclusionAs P-gp and GST-π expressions were higher in tissues resected from control compared with HPT patients, 99mTc-MIBI may wash out faster from normal parathyroid tissue surrounding the lesion compared with the lesion itself, facilitating detection.

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Using technetium 99m tetrofosmin parathyroid imaging to detect parathyroid adenoma and its relation to P-glycoprotein expression

Cited by 5 publications

References 10 publications

Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

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

Dual-phase 99mTc-MIBI imaging and the expressions of P-gp, GST-π, and MRP1 in hyperparathyroidism

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