title: Single radionuclide scintigraphy with 99mtechnetium-sestamibi and ultrasonography in hyperparathyroidism.
abstract: OBJECTIVE
  Assessment of 99mTechnetium-sestamibi scintigraphy and ultrasonography as methods of locating enlarged parathyroid glands before operation.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  University hospital, The Netherlands.
  
  
  METHODS
  21 patients with primary hyperparathyroidism and 6 patients with persistent or recurrent hyperparathyroidism.
  
  
  METHODS
  Single radionuclide scintigraphy with 99mTc-sestamibi, ultrasonography of the neck, and parathyroidectomy.
  
  
  METHODS
  Operative findings, postoperative serum calcium concentrations.
  
  
  RESULTS
  99mTc-sestamibi scintigraphy correctly identified 17 of 21 parathyroid tumours in patients who were about to undergo their first parathyroidectomy (sensitivity = 81%) with a positive predictive value of 94% and all 6 in patients with persistent or recurrent hyperparathyroidism. Ultrasonography correctly identified 13 parathyroid tumours in 18 patients about to undergo their first parathyroidectomy (sensitivity = 72%) with a positive predictive value of 93%, but only 3 among the 6 patients with persistent or recurrent hyperparathyroidism.
  
  
  CONCLUSIONS
  Single radionuclide scintigraphy with 99mTc-sestamibi seems to identify the sites of parathyroid tumours accurately in patients with persistent or recurrent hyperparathyroidism but is not recommended for patients with primary hyperparathyroidism. Combining scintigraphy with ultrasonography does not improve the accuracy.
authors.affiliation: Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
authors.forename: H A
authors.initials: HA
authors.lastname: Bruining
authors.forename: R
authors.initials: R
authors.lastname: Valkema
authors.forename: J S
authors.initials: JS
authors.lastname: Lameris
authors.forename: W W
authors.initials: WW
authors.lastname: de Herder
authors.forename: E
authors.initials: E
authors.lastname: van der Harst
authors.forename: H A
authors.initials: HA
authors.lastname: Pols
mesh_terms: D000328:Adult; D000368:Aged; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012008:Recurrence; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography
chemical_list: D017256:Technetium Tc 99m Sestamibi