USE OF TECHNETIUM TC-99M SESTAMIBI AND IODINE 123 RADIONUCLIDE SCAN FOR PREOPERATIVE LOCALIZATION OF ABNORMAL PARATHYROID-GLANDS IN PRIMARYHYPERPARATHYROIDISM

The imaging methods currently used to localize the parathyroid gland i n patients with hyperparathyroidism have been criticized as unreliable and even misleading. We evaluated a new imaging technique that uses t echnetium Tc 99m sestamibi and iodine 123. We studied 21 patients havi ng a diagnosis of primary hyperparathyroidism and no previous parathyr oid surgery. Scintigraphy to localize the abnormal parathyroid was don e before operation. A solitary adenoma was localized in 14 patients. S ix patients had images consistent with diffuse hyperplasia, and one pa tient had a dual adenoma. The surgical and histologic findings confirm ed the preoperative data. The sensitivity of this method is 87.5%, the specificity is 100%, and the predictive value is 100%. This new metho d of preoperative localization of abnormal parathyroid glands is usefu l in patients having initial neck exploration for primary hyperparathy roidism.