Preoperative detection of parathyroid adenomas with Tc-99m MIBI and Tc-99m pertechnetate scintigraphy: histopathological and biochemical correlation with Tc-99m MIBI uptake.
OBJECTIVE
The objective of this study was to compare the dual phase MIBI scinitgraphy with MIBI and Tc-99m pertechnetate (MIBI + Tc-99m) study in defining the parathyroid adenomas, and to evaluate the effect of histologic and biochemical characteristics on the imaging of parathyroid adenomas with Tc-99m methoxyisobutylisonitrile (MIBI) scintigraphy.


METHODS
Thirty-six patients with parathyroid adenomas were studied prospectively. All patients were evaluated with both MIBI and (MIBI + Tc-99m) study. MIBI uptake of adenomas correlated with oxyphill, chief cell and tumour weight of the surgically excised glands. MIBI uptake was also compared with serum calcium (Ca), phosphorus (P) and intact parathormone (iPTH) levels.


RESULTS
A total of 38 parathyroid adenomas were surgically excised from 36 patients. MIBI + Tc-99m identified 35 of the parathyroid lesions (92%). Whereas, MIBI study detected 30 of the 38 parathyroid adenomas (79% sensitivity) (p=0.0001). There were no false positives. Adenoma weight showed significiant correlation with MIBI uptake (p=0.001). Oxyphyill cell content also showed high correlation with MIBI uptake. Delayed images showed better correlation than the early views (Early MIBI p=0.033; Delayed MIBI; p=0.001).


CONCLUSIONS
MIBI + Tc-99m pertechnetate interpretation is more sensitive than only dual MIBI imaging for the detection of parathyroid adenoma. Oxyphill cell content and weight of the lesions proved to be important determinants of 99mTc-MIBI accumulation in parathyroid adenoma. We found no significant correlation between MIBI accumulation, Ca, P and iPTH serum levels (Tab. 2, Fig. 2, Ref. 15). Full Text (Free, PDF) www.bmj.sk.
Akin
Murat
M
Gazi University Medical School, Department of General Surgery, Ankara, Turkey. makin@gazi.edu.tr
Atasever
Tamer
T
Kurukahvecioglu
Osman
O
Dogan
Mehmet
M
Gokaslan
Devrim
D
Poyraz
Aylar
A
Koksal
Hande
H
Taneri
Ferit
F
D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m; D017256:Technetium Tc 99m Sestamibi; D055815:Young Adult
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m