Elsevier

Clinical Radiology

Volume 56, Issue 7, July 2001, Pages 556-559
Clinical Radiology

Regular Article
Pre-operative Sestamibi–Technetium Subtraction Scintigraphy in Primary Hyperparathyroidism: Experience with 156 Consecutive Patients

https://doi.org/10.1053/crad.2001.0701Get rights and content

Abstract

AIM: The aim of this study was to assess the usefulness of pre-operative sestamibi–technetium subtraction scintigraphy in a large cohort of patients with primary hyperparathyroidism (HPT). MATERIALS AND METHODS: A group of 156 consecutive patients with biochemically proven HPT underwent sestamibi–technetium subtraction scintigraphy before cervical exploration. Images were interpreted and reported prospectively and influenced the extent of surgical exploration. The intraoperative findings were compared retrospectively with the pre-operative scintigram reports in 154 individuals with technically satisfactory scintigrams. RESULTS: Of the 154 patients with satisfactory scintigrams, 122 (78.2%) demonstrated a single focus of activity following subtraction, 31 (19.9%) had negative findings and the remaining scintigram showed four foci of activity. At operation 138 (89.6%) solitary adenomas were removed, 13 patients (8.4%) had multi-gland disease and in three individuals (2.0%) no abnormal parathyroid tissue was found. The pre-operative scintigram accurately localized 91 of 98 (92.9%) solitary tumours weighing > 500 mg but only 18 of 35 (51.4%) adenomas weighing < 500 mg, (P < 0.0001). Overall sensitivity of sestamibi–technetium scintigraphy for localizing single parathyroid adenomas was 83.7%. CONCLUSION: Sestamibi–technetium subtraction scintigraphy will accurately localize a high proportion of solitary parathyroid adenomas but its usefulness is diminished by its inability to consistently identify smaller tumours. Jones, J. M.et al. (2001). Clinical Radiology56, 556–559.

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Author for correspondence and guarantor of study: Mr C. F. J. Russell, Ward 37, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, U.K. Fax: +44(0)28 90 263195

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