COMBINED TC-99M MIBI AND TC-99M RBC FOR ANATOMIC LOCALIZATION OF ECTOPIC MEDIASTINAL PARATHYROID ADENOMAS

Preoperative localization of abnormal parathyroid tissue in patients w ith persistent or recurrent hyperparathyroidism is recommended as a st andard of care. A high percentage of these patients have ectopic tissu e in the mediastinum. Tc-99m MIBI imaging alone for detection of ectop ic parathyroid tissue in the mediastinum does not provide a sufficient number of anatomic landmarks, which makes communication regarding the exact location of any area of abnormal uptake difficult. We report th e use of concomitant Tc-99m RBC and Tc-99m MIBI imaging for precise an atomic localization of ectopic mediastinal parathyroid tissue in 4 pat ients. It is thought that this combination of studies allows improved communication with referring physicians, surgeons, and radiologists fo r planning both surgical approach and correlative imaging studies. It is hoped that in the future this combination of studies may obviate th e need for other imaging studies.