title: Preliminary experience with double-phase SPECT using Tc-99m sestamibi in patients with hyperparathyroidism.
abstract: BACKGROUND
  There is a continual search for a better imaging modality for parathyroid pathology. In recent years, Tc-99m sestamibi has been proposed as an alternative to T1-201 for parathyroid scintigraphy. The purpose of this study is to assess the usefulness of a double-phase Tc-99m sestamibi SPECT technique for parathyroid imaging.
  
  
  METHODS
  Sixty-one consecutive patients with hyperparathyroidism were studied. Sixteen had previously undergone unsuccessful surgery for hyperparathyroidism. SPECT imaging of the neck and chest was performed at 15 minutes and again at 2 hours after 20-25 mCi of Tc-99m sestamibi was given intravenously. A positive scan was defined as a region of increased focal uptake that persisted on the delayed images.
  
  
  RESULTS
  When compared with surgical findings, double-phase sestamibi SPECT correctly identified 55% (26/ 47) of the parathyroid adenomas in the previously unoperated group, and 91% (10/11) of the parathyroid adenomas in the reoperative group. Double-phase sestamibi SPECT was negative in 92% (109/118) of the normal parathyroid glands in the previously unoperated group, and in 88% (15/17) in the reoperative group.
  
  
  CONCLUSIONS
  These preliminary data suggest that double-phase Tc-99m sestamibi SPECT is a promising procedure for the preoperative detection and localization of hyperfunctioning parathyroid tissue, especially in patients with recurrent or persistent postoperative hyperparathyroidism.
authors.affiliation: Department of Nuclear Medicine, Cleveland Clinic Foundation, Ohio 44195-5074, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Neumann
authors.forename: C B
authors.initials: CB
authors.lastname: Esselstyn
authors.forename: E Y
authors.initials: EY
authors.lastname: Kim
authors.forename: R T
authors.initials: RT
authors.lastname: Go
authors.forename: N A
authors.initials: NA
authors.lastname: Obuchowski
authors.forename: T W
authors.initials: TW
authors.lastname: Rice
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D016105:Parathyroidectomy; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D012008:Recurrence; D012086:Reoperation; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi