[High retention of (99m)Tc-MIBI in delayed phase as a pitfall in the combined parathyroid-thyroid scintigraphy].
Dual phase parathyroid scintigraphy with (⁹⁹m)Tc-sestaMIBI is a very sensitive technique in the preoperative localization and diagnosis of parathyroid adenoma. However, pitfalls have been reported in patients with thyroid nodules with MIBI uptake or with previous thyroid surgery. To solve this problem, a thyroid scintigraphy with (⁹⁹m)Tc-pertechnetate is usually performed following the parathyroid study. Occasionally, as in our patient the parathyroid lesion may show high MIBI uptake and delayed washout that interfere with the subsequent thyroid scintigraphy giving the false appearance of a pertechnetate avid lesion. This has been called the «shine through» effect. To avoid it, the parathyroid and thyroid scintigraphies can be performed on separate days. We have also found it useful to compare our results with that of ultrasound and fine needle aspiration puncture with measurement of the parathyroid hormone (PTH) and thyroglobulin in the aspirated material.
Verdú
J
J
Servicio de Medicina Nuclear, Hospital Universitario de San Juan de Alicante, San Juan de Alicante, Alicante, España. verdu_jos@gva.es
Lizárraga
C
C
Clavel
J
J
Prata
I
I
Calbo
J
J
Pomares
F
F
D000236:Adenoma / Q000000981:diagnostic imaging*; D000368:Aged; D016477:Artifacts; D044963:Biopsy, Fine-Needle; D003560:Cysts / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D010280:Parathyroid Glands / Q000737:chemistry / Q000000981:diagnostic imaging*; D010281:Parathyroid Hormone / Q000032:analysis; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D013670:Sodium Pertechnetate Tc 99m; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics*; D013954:Thyroglobulin / Q000032:analysis; D013961:Thyroid Gland / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography
D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D013954:Thyroglobulin; D017256:Technetium Tc 99m Sestamibi; D013670:Sodium Pertechnetate Tc 99m