+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Sestamibi scan for preoperative localization in primary hyperparathyroidism

Sestamibi scan for preoperative localization in primary hyperparathyroidism

Head & Neck 19(2): 87-91

Background: Various invasive and noninvasive localizing tests are available for the evaluation of primary hyperparathyroidism. The surgical success in primary intervention exceeds 90% without localization studies. However, localization tests are absolutely essential for re-exploration and in certain select circumstances, even in primary exploration. The traditional noninvasive localization studies include the sonogram, thallium-technetium scan, computed tomography (CT) scan, and magnetic resonance imaging (MRI). The purpose of this report is to review our recent experience with sestamibi scan. The sestamibi scan appears to be the most sensitive and accurate noninvasive test available today. Methods: Technetium 99m sestamibi has recently been used for parathyroid localization, in conjunction with iodine-123 subtraction. We have evaluated 24 patients with suspected primary hyperparathyroidism to study the role of technetium 99m sestamibi scan. T-c-sestamibi was used either with or without iodine-123 for subtraction of thyroid activity. Results: None of these patients had renal failure or secondary hyperparathyroidism. Of 24 patients, the parathyroid adenoma was localized by scintigraphy in 19 patients. Twenty patients underwent surgical exploration. In 17 patients there was a complete correlation between the imaging study and the operative findings (positive predictive value, 89%). There were no false positives in this series. The interpretation of the parathyroid images was relatively easy; however, the depth of the adenoma could not be predicted, based on the scan alone. The largest adenoma weighed 2.7 g, the smallest, 700 mg. Conclusion: This newer radiopharmaceutical, technetium 99m sestamibi, appears to be quite useful and accurate in the preoperative localization of patients with primary hyperparathyroidism. Parathyroid enlargement can also be studied by sestamibi imaging alone if delayed imaging is performed.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 009407148

Download citation: RISBibTeXText

PMID: 9059864

DOI: 10.1002/(sici)1097-0347(199703)19:2<87::aid-hed1>3.0.co;2-q

Related references

Use of technetium Tc 99m sestamibi and iodine 123 radionuclide scan for preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism. Southern Medical Journal 87(3): 336-339, 1994

Prospective comparison of technetium-99m-sestamibi/iodine-123 radionuclide scan versus high-resolution ultrasonography for the preoperative localization of abnormal parathyroid glands in patients with previously unoperated primary hyperparathyroidism. American Journal of Surgery 166(4): 369-373, 1993

Primary hyperparathyroidism: preoperative localization using technetium-sestamibi scanning. Journal of Clinical Endocrinology and Metabolism 80(1): 7, 1995

Analysis of savings in operative time for primary hyperparathyroidism using localization with technetium 99m sestamibi scan. American Journal of Surgery 170(5): 488-491, 1995

Cost-effectiveness of preoperative sestamibi scan for primary hyperparathyroidism is dependent solely upon the surgeon's choice of operative procedure. Journal of the American College of Surgeons 186(3): 293-305, 1998

Technetium-99m-sestamibi single agent localization versus high resolution ultrasonography for the preoperative localization of parathyroid glands in patients with primary hyperparathyroidism. American Surgeon 61(10): 882-888, 1995

Sestamibi (99mTc) scan as a single localization modality in primary hyperparathyroidism and factors impacting its accuracy. Indian Journal of Nuclear Medicine 25(1): 6-9, 2010

Are additional localization studies and referral indicated for patients with primary hyperparathyroidism who have negative sestamibi scan results?. Archives of Surgery 145(6): 578-581, 2010

Primary hyperparathyroidism patients with positive preoperative sestamibi scan and negative ultrasound are more likely to have posteriorly located upper gland adenomas (PLUGs). Annals of Surgical Oncology 18(6): 1717-1722, 2011

Technetium-99m-sestamibi/pertechnetate subtraction scintigraphy vs ultrasonography for preoperative localization in primary hyperparathyroidism. European Radiology 12(3): 605-609, 2002

Preoperative localization of parathyroid adenoma with sonography and 99mTc-sestamibi scintigraphy in primary hyperparathyroidism. Journal of Clinical Ultrasound 35(4): 186-190, 2007

Early-phase technetium-99m sestamibi scintigraphy can improve preoperative localization in primary hyperparathyroidism. American Journal of Surgery 205(3): 269-73; Discussion 273, 2013

A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism. American Journal of Surgery 193(2): 155-159, 2007

Correlation of plasma 25-hydroxyvitamin D levels with severity of primary hyperparathyroidism and likelihood of parathyroid adenoma localization on sestamibi scan. Archives of Otolaryngology--Head & Neck Surgery 134(10): 1071-1075, 2008

Prospective evaluation of delayed technetium-99m sestamibi SPECT scintigraphy for preoperative localization of primary hyperparathyroidism. Surgery (St Louis) 131(2): 149-157, 2002