title: Comparison of histological findings and parathyroid scintigraphy in hemodialysis patients with secondary hyperparathyroid glands.
abstract: To determine the usefulness of parathyroid scintigraphy in histological estimation for secondary hyperparathyroidism (2HPT) using Tc-99m sestamibi or Tc-99m tetrofosmin. Tc-99m sestamibi (MIBI) and Tc-99m tetrofosmin (Tetro) parathyroid imaging following double-phase study, magnetic resonance imaging (MRI), and ultrasound were performed on 14 patients with 2HPT. All patients underwent parathyroidectomy. The uptake of two tracers in parathyroid areas was compared with the histopathologic findings. Forty-nine parathyroid glands were surgically explored and histologically proven to be hyperplastic. Of these, 42 were diagnosed with nodular type (N-type) hyperplasia, and 7 with diffuse type (D-type) hyperplasia. MIBI and Tetro parathyroid imagings detected 34 and 35 parathyroid glands, respectively. The sensitivity of MIBI was determined to be 76.2% (32/42) for N-type, and 28.6% (2/7) for D-type. The sensitivity of Tetro was determined to be 78.6% (33/42) for N-type and 28.6% (2/7) for D-type. The sensitivity of both MIBI and Tetro was significantly higher for N-type than for D-type, 76.2% (32/42) vs. 28.6% (2/7) in MIBI, P = 0.022; 78.6% (33/42) vs. 28.6% (2/7) in Tetro, P = 0.015. The sensitivity of MRI was determined to be 76.2% (32/42) for N-type and 42.9% (3/7) for D-type, and the sensitivity of ultrasound was 71.4% (30/42) for N-type and 71.4% (5/7) for D-type. There was no significant difference in the sensitivity of MRI or ultrasound between N-type and D-type. The uptake ratios of MIBI and Tetro were also greater for N-type than for D-type. The detectability of both MIBI and Tetro was greater for N-type than for D-type. Tc-99m MIBI or Tc-99m Tetro parathyroid scintigraphy therefore may be used clinically to distinguish N-type from D-type parathyroid gland hyperplasia.
authors.affiliation: Department of Nephrology and Dialysis Unit, Kurume University School of Medicine, Asahimachi, Fukuoka, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Nishida
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishibashi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiromatsu
authors.forename: Hayato
authors.initials: H
authors.lastname: Kaida
authors.forename: Kenkichi
authors.initials: K
authors.lastname: Baba
authors.forename: Ikuyo
authors.initials: I
authors.lastname: Miyake
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ikedo
authors.forename: Seiya
authors.initials: S
authors.lastname: Kato
authors.forename: Kei
authors.initials: K
authors.lastname: Fukami
authors.forename: Shuji
authors.initials: S
authors.lastname: Iida
authors.forename: Seiya
authors.initials: S
authors.lastname: Okuda
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging* / Q000473:pathology*; D006965:Hyperplasia; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000473:pathology*; D011877:Radionuclide Imaging; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi