title: Efficacy of preoperative dual-phase sestamibi scanning in hyperparathyroidism.
abstract: OBJECTIVE
  The objective of this article is to evaluate our experience with sestamibi scanning in patients with primary and secondary hyperparathyroidism.
  
  
  METHODS
  A retrospective review of patients referred to the radiology department at the University of Kansas Medical Center for parathyroid studies between January 1, 1993, and August 1, 1998, was done. Patients included in the study were those who underwent both dual-phase technetium (Tc-99m) sestamibi scanning and subsequent parathyroidectomy at our institution (n = 34). Twenty-six patients had primary hyperparathyroidism and 8 patients had secondary hyperparathyroidism. Fifteen had previous history of neck exploration.
  
  
  RESULTS
  Sensitivity of sestamibi scans in detection of all abnormal pathology in cases of primary hyperparathyroidism was 60% overall. Among the subset of adenoma cases, sensitivity was 82% (14/17). Among cases of primary parathyroid hyperplasia, no scan correctly localized all abnormal glands; however 60% (3/5) showed localization of at least one hyperplastic gland. Of the 2 patients with parathyroid carcinoma, in only one case was there evidence of sestamibi retention in the correct thyroid lobe. In patients with secondary hyperparathyroidism, sestamibi scanning was successful in identifying all hyperplastic tissue in only one case (sensitivity 13%). In 7 of the 8 cases of secondary hyperparathyroidism, the scan localized at least one hyperplastic gland.
  
  
  CONCLUSIONS
  Sestamibi scanning is useful in the localization of abnormal pathology in cases of primary hyperparathyroidism, especially adenomas. In cases of hyperplasia, whether attributable to primary or secondary hyperparathyroidism, sestamibi imaging is less successful.
authors: Department of Otolaryngology--Head and Neck Surgery, Vanderbilt, Nashville, TN, USA.
authors: C W
authors: CW
authors: Chang
authors: T T
authors: TT
authors: Tsue
authors: A S
authors: AS
authors: Hermreck
authors: K G
authors: KG
authors: Baxter
authors: L A
authors: LA
authors: Hoover
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000601:surgery; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016105:Parathyroidectomy; D011300:Preoperative Care; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi