Pre-surgical localization of ectopic parathyroid glands using three-dimensional CT imaging, Tc-99(m) sestamibi, and Tc-99(m) tetrofosmin imaging

We describe two patients with ectopic parathyroid glands evaluated with Tc- 99(m) sestamibi, Tc-99(m) tetrofosmin, and three-dimensional computed tomog raphy (3D-CT). Radionuclide images of the neck were acquired at 10 min, and at 2-3 h after radiopharmaceutical injection, and showed intense uptake in the ectopic parathyroid tissue. These patients also underwent contrast enh anced CT imaging with 3D reconstructions which were evaluated for ability t o visualize critical anatomical structures, e.g. blood vessels and parathyr oid glands. Based on 3D-CT images, surgical planning was altered in one of the two patients studied. In conclusion, reconstructed 3D-CT images provide d useful anatomical localization of ectopic parathyroid glands identified o n Tc-99(m) sestamibi and Tc-99(m) tetrofosmin imaging. This anatomical info rmation aided surgical planning of gland resection.