[Preoperative localization of parathyroid adenoma with technetium and thallium double-labeling scintigraphy. Difficulties related to associated thyroid lesions].
Technetium and thallium double-labeling scintigraphy with image subtraction was carried out on 63 patients suspected of having primary hyperparathyroidism, with or without thyroid involvement. Forty-four patients had a normal thyroid image with technetium. The positive foci located by double-labeling in patients who were to undergo surgery always coincided with parathyroid adenoma. In the 16 cases where the initial diagnosis of hyperparathyroidism was not substantiated, the double-labeling test was normal. Thus for these 44 patients, scintigraphy sensitivity was 75% and specificity was 100%. Nineteen patients had an abnormal thyroid image with technetium. In 7 cases, image subtraction following double-labeling yielded uninterpretable data. In 12 other patients, the positive foci located outside the thyroid by double-labeling coincided with a parathyroid adenoma, whereas this was true for only one patient whose positive foci were located inside the thyroid; a parathyroid adenoma was not detected preoperatively in 4 patients. This double-labeling test is thus useful in locating parathyroid adenomas when technetium scintigraphy of the thyroid is normal; when it is abnormal, double-labeling is advantageous only in cases of extra-thyroid foci.
Valensi
P
P
Clinique Endocrinologique, Hôpital Avicenne, Bobigny.
Bedig
G
G
Paycha
F
F
Tellier
P
P
Sarfati
E
E
Attali
J R
JR
Dubost
C
C
Sebaoun
J
J
Vulpillat
M
M
D000236:Adenoma / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D006801:Humans; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013382:Subtraction Technique; D013667:Technetium; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D013667:Technetium
Localisation préopératoire des adénomes parathyroïdiens par la scintigraphie en double marquage, technétium et thallium. Difficulties liées aux lésions thyroïdiennes associées.