TC-99M SESTAMIBI PARATHYROID LOCALIZATION IS ACCURATE ENOUGH FOR SCAN-DIRECTED UNILATERAL NECK EXPLORATION

A retrospective study was conducted into technetium-99m sestamibi imag ing of primary hyperparathyroidism to determine the accuracy of identi fication and localization of parathyroid pathology. Of 56 patients stu died, 48 had full preoperative scan data, operative data and pathologi cal results analysed. Overall scan accuracy was 96 per cent. For singl e gland pathology (adenoma) imaging had a sensitivity of 97 per cent, a specificity of 100 per cent and a positive predictive value of 100 p er cent. For single gland disease the side was correctly identified in 100 per cent of cases and the site in 94 per cent, but the respective values were only 82 and 79 per cent for multiple gland pathology. Tec hnetium-99m sestamibi imaging is highly sensitive and accurate for pri mary hyperparathyroidism, with sufficient positive predictive value an d accuracy in single gland disease to allow scan-directed unilateral n eck exploration.