Dual-phase 99mTc-MIBI scintigraphy to assess calcimimetic effect in patients on haemodialysis with secondary hyperparathyroidism.
OBJECTIVE
To evaluate the effect of calcimimetics with 99mTc-methoxy-isobutyl-isonitrile (MIBI) parathyroid scintigraphy in secondary hyperparathyroidism.


METHODS
This prospective study included 30 consecutive haemodialysis patients with inadequately controlled secondary hyperparathyroidism despite standard medical treatment. Patients were given a single daily oral dose of 30 mg of cinacalcet. A baseline and 1-year follow-up dual-phase 99mTc-MIBI scintigraphy were performed. 99mTc-MIBI uptake in each parathyroid gland was graded on a semiquantitative scale (scoring 0-3).


RESULTS
Twenty-one of the 30 patients responded to cinacalcet (70%). Abnormal positive glands were identified by 99mTc-MIBI scintigraphy in 27 out of 30 patients (53 glands). The sensitivity and specificity of 99mTc-MIBI in detecting cinacalcet response were 90 and 89%, respectively. The mean baseline and posttreatment grades of 99mTc-MIBI uptake were 2.9 ± 1.8 and 1.1 ± 1.2 (P < 0.0001) in the responder group and 3.1 ± 2.1 and 3.9 ± 2.2 (P = ns) in the nonresponder group.


CONCLUSIONS
99mTc-MIBI scintigraphy is useful in monitoring the response to calcimimetics in secondary hyperparathyroidism.
Fuster
David
D
Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain. dfuster@clinic.ub.es
Torregrosa
José-Vicente
JV
Domenech
Beatriz
B
Solà
Oriol
O
Martín
Gloria
G
Casellas
Joan
J
Setoain
Xavier
X
Muxí
Africa
A
Pons
Francesca
F
D000328:Adult; D000368:Aged; D001692:Biological Transport; D057966:Calcimimetic Agents / Q000627:therapeutic use*; D000069449:Cinacalcet; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D011877:Radionuclide Imaging; D006435:Renal Dialysis; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome
D057966:Calcimimetic Agents; D009281:Naphthalenes; D017256:Technetium Tc 99m Sestamibi; D000069449:Cinacalcet