Localization of a parathyroid adenoma by the addition of pinhole imaging to Tc-99m sestamibi dual-phase scintigraphy. Report of a case and review of experience.
Scintigraphy using Tc-99m has been shown to be highly sensitive in localizing abnormal parathyroid glands in patients with hyperparathyroidism. False-negative studies most often are attributed to glandular size or location. The authors report a case of negative parathyroid imaging using standard dual-phase technique, which was converted to a positive study by the addition of a pinhole view. During a 1-year period, the authors systematically added an anterior-pinhole image of the neck to all equivocal or negative Tc-99m studies. Five of 19 patient studies were pinhole-image positive and standard-image negative or equivocal. In selected patients undergoing Tc-99m scintigraphy for hyperparathyroidism, the addition of a pinhole view may enhance study sensitivity and the confidence in interpretation.
Kipper
M S
MS
North County Medi-Scan, Department of Nuclear Medicine, Vista, CA 92083, USA.
LaBarbera
J J
JJ
Krohn
L D
LD
Marcou
L M
LM
D000236:Adenoma / Q000000981:diagnostic imaging*; D000328:Adult; D005188:False Negative Reactions; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging; D007089:Image Enhancement / Q000379:methods*; D008297:Male; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi