Role of radionuclide scintigraphy in the detection of parathyroid adenoma.
BACKGROUND
Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT) scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context.


OBJECTIVE
We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas.


METHODS
Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images) in selected cases.


RESULTS
There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively.


CONCLUSIONS
We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.
Singh
N
N
Department of Nuclear Medicine, P. D. Hinduja National Hospital and MRC, Mumbai, India. drnatasha_singh@yahoo.com
Krishna
B A
BA
D000236:Adenoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi