Relation of biochemical, cytologic, and morphologic parameters to the result of gammagraphy with technetium 99m sestamibi in primary hyperpararthyroidism

The aim of this study was to analyze the possible relation of biochemical, cytologic, and morphologic parameters to the results of parathyroid gammagr aphy with Tc 99m sestamibi in primary hyperparathyroidism. We studied 46 co nsecutive patients with primary hyperparathyroidism who were undergoing sur gery. All the patients were given a preoperative parathyroid gammagraphy wi th To 99m sestamibi and a complete preoperative biochemical study. During t he surgical intervention we recorded the weight and size of the pathologic glands to calculate the volume of each. We also determined the percentage o f the chief and oxyphil cells in the pathologic glands. Tc 99m sestamibi se nsitivity is higher in adenomas (91%) than in hyperplasia (67%) or double a denomas (50%). No relation was found between biochemical or cytologic param eters and gammagraphic results. Weight and gland volume were significantly greater for adenomas than for hyperplasia (P < 0.0014 and P < 0.0004, respe ctively), and statistically significant differences in both of them were ob served between the glands with positive and negative sestamibi.