Single radionuclide scintigraphy with 99mtechnetium-sestamibi and ultrasonography in hyperparathyroidism.
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.
Bonjer
H J
HJ
Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Bruining
H A
HA
Valkema
R
R
Lameris
J S
JS
de Herder
W W
WW
van der Harst
E
E
Pols
H A
HA
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
D017256:Technetium Tc 99m Sestamibi