COMPARISON OF PARATHYROID IMAGING WITH TECHNETIUM-99M-PERTECHNETATE SESTAMIBI SUBTRACTION, DOUBLE-PHASE TECHNETIUM-99M-SESTAMIBI AND TECHNETIUM-99M-SESTAMIBI SPECT/
Cc. Chen et al., COMPARISON OF PARATHYROID IMAGING WITH TECHNETIUM-99M-PERTECHNETATE SESTAMIBI SUBTRACTION, DOUBLE-PHASE TECHNETIUM-99M-SESTAMIBI AND TECHNETIUM-99M-SESTAMIBI SPECT/, The Journal of nuclear medicine, 38(6), 1997, pp. 834-839
The ability of Tc-99m-pertechnetate/sestamibi subtraction, double-phas
e Tc-99m-sestamibi and Tc-99m-sestamibi SPECT imaging to localize abno
rmal parathyroid tissue was compared, Methods: Fifty-five consecutive
patients had parathyroid imaging before surgery for hyperparathyroidis
m, Imaging consisted of Tc-99m-pertechnetate pinhole images of the nec
k followed by Tc-99m-sestamibi pinhole images of the neck and parallel
-hole images of the neck and chest (early images), Within 2.5-4.0 hr l
ater pinhole images of the neck, parallel-hole and SPECT images of the
neck and chest were obtained (late images), Nodular fool of increased
sestamibi activity were considered abnormal, Results: The sensitivity
for abnormal parathyroid glands by visual comparison of early images
and pertechnetate images was 72%-75%, late images and pertechnetate im
ages was 73%-78% and double-phase (early and late) sestamibi images wa
s 62%-65%; computer subtraction of pertechnetate from early images was
71%-74%; and SPECT imaging was 79%. The sensitivity for parathyroid a
denomas was 89%-98%, while the sensitivity for hyperplastic parathyroi
d glands was only 47%-58%. Conclusion: Late imaging, computer subtract
ion and SPECT may not be necessary since they provided only marginal i
mprovements on visual comparison of early sestamibi with pertechnetate
images, Double-phase sestamibi imaging was less sensitive, so baselin
e thyroid imaging with pertechnetate is recommended.