Identifying abnormal parathyroid glands in the thyroid uptake area using technetium-99m-sestamibi and factor analysis of dynamic structures.
A rapid (25 min) single tracer scintigraphic method to localize parathyroid gland abnormalities was evaluated in 24 patients with hyperparathyroidism.


METHODS
Scintigraphy was performed with 99mTc-sestamibi prior to surgery. A 25-min dynamic series centered on the neck was acquired immediately after injection of 99mTc-MIBI. Two planar static views were obtained after 1 and 2 hr. To identify abnormal parathyroid tissue in the thyroid uptake area, a factor analysis of dynamic structure (FADS) was applied to the dynamic acquisition. The results were compared to the analysis of the two planar static views.


RESULTS
FADS demonstrated abnormal uptake of the tracer in the thyroid area for 26 of the 31 parathyroid glands found to be abnormal at surgery (5/6 adenomas, 21/25 hyperplastic glands). In three cases, FADS demonstrated parathyroid uptake despite the absence of parathyroid tissue at surgery. FADS revealed as specific and more sensitive than the visual analysis of the two static views, since only 13/30 glands were still visible after 1 hr, and 5/26 after 2 hr. Furthermore, a study with two static views was found to be less sensitive for the detection of hyperplastic glands.


CONCLUSIONS
FADS99mTc-MIBI is performed in less time than existing scintigraphic protocols. It is a promising method to detect abnormal parathyroid glands in the cervical area with a single tracer.
Billotey
C
C
Service de Médecine Nucléaire, Hôpital Saint-Louis, Paris, France.
Aurengo
A
A
Najean
Y
Y
Sarfati
E
E
Moretti
J L
JL
Toubert
M E
ME
Rain
J D
JD
D000236:Adenoma / Q000000981:diagnostic imaging*; D005163:Factor Analysis, Statistical; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging*; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging*; D007091:Image Processing, Computer-Assisted; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D013997:Time Factors
D017256:Technetium Tc 99m Sestamibi