RECENT PROGRESS IN RADIONUCLID IMAGING OF PARATHYROID-GLANDS

Scintigraphic imaging of parathyroid glands has been the subject of ne w developments. Efficiency of the technique has been improved by the u se of a new agent Tc-99m sestamibi (MIBI). A meta-analysis study of th e literature confirmed the superiority of this agent toward the conven tional Tc/T1201. Various protocols have been proposed for parathyroid imaging with MIBI they are described with a comparison of their advant ages and drawbacks. The superiority of a two isotopes protocol using T c-99m sestamibi with Iodine 123 and a subtraction processing seems pro ven. Moreover this latter protocol allows the use of lateral views res ulting in a higher accuracy. The visualization of hyperplasic glands i s also improved by this technique. Comparison of ultrasonography versu s Tc-99m sestamibi scintigraphy is discussed in the light of recent pu blished materials. The scintigraphy appears more sensitive than ultras onography and specially in the detection of mediastinal ectopic glands . Finally the exact role of radionuclid imaging of the parathyroids in the management of primary hyperparathyroidism is described.