Pre-operative localization and tissue uptake study in parathyroid imaging with technetium-99m-sestamibi.
BACKGROUND
The diagnostic ability of 99mTc-sestamibi was compared with other techniques and the mechanism of parathyroid uptake was investigated.


METHODS
Double-phase 99mTc-sestamibi scanning was performed in 52 primary and 28 renal hyperparathyroidism patients. Gene expressions of mdr1 and mrp were examined by reverse transcriptase polymerase chain reaction in parathyroid tissue.


RESULTS
The sensitivity of 99Tc-sestamibi in primary and renal hyperparathyroidism was 91% and 75%, respectively, higher than for ultrasonography, T1/Tc subtraction scintigraphy, or computed tomography. Early 99mTc-sestamibi uptake was washed out in delayed images in 7% and 30% of glands in primary and renal hyperparathyroidism, respectively. Expression of mdr1 and mrp mRNA was found in 5 of 23 and 16 of 31 glands, respectively, and their expression correlated with washout in delayed images.


CONCLUSIONS
99mTc-sestamibi was the best localization test. mdr1 and mrp were associated with 99Tc-sestamibi washout, but their role in the parathyroid remains unclear.
Takami
H
H
First Department of Surgery, Teikyo University School of Medicine, Itabashi, Tokyo, Japan. takami@med.teikyo-u.ac.jp
Oshima
M
M
Sugawara
I
I
Satake
S
S
Ikeda
Y
Y
Nakamura
K
K
Kubo
A
A
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics; D000328:Adult; D000368:Aged; D005260:Female; D019450:Genes, MDR; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery; D007669:Kidney Calculi / Q000150:complications; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics*; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000378:metabolism
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi