title: [Detection and localization of enlarged parathyroid glands in patients with hyperparathyroidism using 99mTc-methoxyisobutylisonitrile (MIBI): a study of subtraction scintigraphy with 99mTc-pertechnetate].
abstract: In this study we investigated the detectability of abnormal parathyroid gland(s) by 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy in patients with hyperparathyroidism. The subjects were 6 patients with primary hyperparathyroidism (PHP) with a single adenoma and 13 patients with renal hyperparathyroidism (RHP) on chronic maintenance hemodialysis. The imaging data of 99mTc-pertechnetate were subtracted from those of 99mTc-MIBI (MIBI-Tc), and number and location of the positive images on scintigrams were compared with those obtained by conventional scintigraphy using 201Tl-Cl and 99mTc-pertechnetate (Tl-Tc). All of the patients underwent surgery, and the number and location of the abnormal parathyroid glands were confirmed. The number of resected parathyroid glands were 6 in PHP and 52 in RHP. The detectability of MIBI-Tc was 83.3% in PHP and 51.9% in RHP, while that of Tl-Tc was 100% and 44.2%, respectively. Although no statistically significant difference in the detectability was found between MIBI-Tc and Tl-Tc, the number of false positives with MIBI-Tc was less than that with Tl-Tc. The detectability of MIBI-Tc depended on the size of the parathyroid gland. The maximal diameter and weight of the smallest parathyroid gland detected were 15 mm and 290 mg in PHP, and 9 mm and 50 mg in RHP. The existence of the thyroid gland did not reduce the detectability of MIBI-Tc. In conclusion, MIBI-Tc was clinically very useful for the detection of abnormal parathyroid glands in patients with hyperparathyroidism.
authors.affiliation: Department of Endocrine Surgery, Kawasaki Medical School.
authors.forename: M
authors.initials: M
authors.lastname: Katagiri
authors.forename: T
authors.initials: T
authors.lastname: Ohtawa
authors.forename: N
authors.initials: N
authors.lastname: Otsuka
authors.forename: K
authors.initials: K
authors.lastname: Morita
authors.forename: T
authors.initials: T
authors.lastname: Sone
authors.forename: H
authors.initials: H
authors.lastname: Mimura
authors.forename: S
authors.initials: S
authors.lastname: Yanagimoto
authors.forename: M
authors.initials: M
authors.lastname: Fukunaga
authors.forename: T
authors.initials: T
authors.lastname: Harada
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging / Q000379:methods; D013670:Sodium Pertechnetate Tc 99m; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m