Parathyroid gland radionuclide scanning--methods and indications.
The usefulness of preoperative radionuclide scanning of the parathyroid glands in patients with primary or secondary hyperparathyroidism was long controversial because available techniques were of limited diagnostic efficacy. Technetium-99m-labeled sestamibi (99Tc-sestamibi) is a new radiopharmaceutical agent easily detected by gamma cameras. The first parathyroid imaging studies done with 99Tc-sestamibi about 10 years ago used a double-phase technique to separate thyroid and parathyroid tissue. Although promising, this method was less than ideal, particularly in multiple gland primary hyperparathyroidism and in secondary hyperparathyroidism. For several years, we have been using subtraction between two images acquired simultaneously, one with 99Tc-sestamibi, which binds to thyroid and parathyroid tissue, and the other with 123-iodine, which binds only to thyroid tissue. The remarkable efficacy of this technique in both primary and secondary hyperparathyroidism invites a reappraisal of the place of radionuclide imaging as a preoperative localization procedure done to reduce the need for repeat surgery. The usefulness of this technique in selecting candidates for unilateral surgery among patients with primary hyperparathyroidism is discussed.
Hindié
Elif
E
Nuclear medicine department, hĵpital Saint-Antoine, Paris, France. elif.hindie@sat.ap-hop-paris.fr
de
Labriolle-Vaylet Claire
LV
Mellière
Didier
D
Jeanguillaume
Christian
C
Urena
Pablo
P
Perlemuter
Léon
L
Askienazy
Serge
S
D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis / Q000601:surgery; D007457:Iodine Radioisotopes; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D017256:Technetium Tc 99m Sestamibi; D014055:Tomography, Emission-Computed / Q000379:methods*
D007457:Iodine Radioisotopes; D017256:Technetium Tc 99m Sestamibi