title: The utility of 99mTc-sestamibi scintigraphy in the localisation of parathyroid adenomas in primary hyperparathyroidism.
abstract: BACKGROUND
  There are conflicting data in the literature about the sensitivity of sestamibi scintigraphy in parathyroid tumour localisation in primary hyperparathyroidism (PHPT).
  
  
  OBJECTIVE
  We aimed to evaluate the overall sensitivity of this modality in parathyroid tumour localisation and to determine clinical and biochemical factors which influence sensitivity of this method.
  
  
  METHODS
  We performed a retrospective review of 57 patients with a biochemical diagnosis of PHPT who had sestamibi scintigraphy performed.
  
  
  RESULTS
  The sensitivity of sestamibi scanning was 56% in whole group and 63% in those without nodular thyroid disease. Among the patients with confirmed single gland disease (biochemical cure after surgical removal of a single adenoma), sensitivity was 71%. A positive scan was associated with younger age, greater adenoma weight and higher pre-operative serum calcium. Concordance between the sestamibi and neck ultrasonography was 92% accurate in pre-operative tumour localisation.
  
  
  CONCLUSIONS
  Sestamibi scintigraphy was more likely to be positive in younger patients without nodular thyroid disease who have larger parathyroid adenomas with more severe hyperparathyroidism.
authors.affiliation: Division of Endocrinology, Beaumont Hospital, RCSI Medical School, Dublin 9, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: Glynn
authors.forename: N
authors.initials: N
authors.lastname: Lynn
authors.forename: C
authors.initials: C
authors.lastname: Donagh
authors.forename: R K
authors.initials: RK
authors.lastname: Crowley
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: C J
authors.initials: CJ
authors.lastname: Thompson
authors.forename: A D K
authors.initials: AD
authors.lastname: Hill
authors.forename: F
authors.initials: F
authors.lastname: Keeling
authors.forename: A
authors.initials: A
authors.lastname: Agha
mesh_terms: D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi