title: Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report.
abstract: BACKGROUND
  Tc-sestamibi is the most frequently used radionuclide agent for the detection of parathyroid adenomas in the clinical setting. However, Tc-tetrofosmin is another such agent that may be used for this purpose. This case report presents the significance and practicality of 99mTc-tetrofosmin for the diagnosis of parathyroid adenomas with probable high p-glycoprotein levels.
  
  
  METHODS
  A 45-year-old woman was referred to our Nuclear Department with a palpable neck nodule suspicious for parathyroid adenoma. She had no significant medical history or other accompanying symptoms. Blood examination results were normal with the exception of the parathormone level which was high at 167.2 pg/ml. Neck ultrasonography revealed a hypoechoic mass near the lower pole of the thyroid gland. 99m Tc-tetrofosmin dual-phase scintigraphy with early and delayed images was performed and the results supported the presupposition of parathyroid adenoma as shown by increased radiopharmaceutical levels near the lower left thyroid gland on the early image that disappeared on the delayed image. Moreover, TcO4- thyroid scintigraphy results excluded thyroid pathology. Two months after the diagnosis, parathyroidectomy was successfully performed without postoperative complications. The pathology report and clinical response to a gradual decrease of parathormone confirmed the initial diagnosis.
  
  
  CONCLUSIONS
  We strongly recommend the use of reverse 99m Tc-tetrofosmin scintigraphy as a useful and safe examination technique for the diagnosis of parathyroid adenomas.
authors.affiliation: Second Department of Surgery, Medical School, Democritus University of Thrace, Dragana, Alexandroupolis 68100, Greece. romanidis@yahoo.com.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Romanidis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Karathanos
authors.forename: Eleni-Aikaterini
authors.initials: EA
authors.lastname: Nagorni
authors.forename: Alexandra
authors.initials: A
authors.lastname: Giatromanolaki
authors.forename: Efthimios
authors.initials: E
authors.lastname: Sibridis
authors.forename: Athanassios
authors.initials: A
authors.lastname: Zissimopoulos
authors.forename: Theodosia
authors.initials: T
authors.lastname: Vogiatzaki
authors.forename: Constantinos
authors.initials: C
authors.lastname: Simopoulos
authors.forename: Michael
authors.initials: M
authors.lastname: Pitiakoudis
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin