| Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism. | |
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MedLine Citation:
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PMID: 15888097 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Minimally invasive parathyroid surgery in patients with primary hyperparathyroidism (PHPT) demands high imaging accuracy. By increasing blood flow to the parathyroid adenoma before injection of a perfusion marker, we intended to improve the parathyroid scintigraphy. We have named the technique stimulated parathyroid scintigraphy (SPS). METHODS: Twenty minutes after injection of 100 MBq (99m)Tc-pertechnetate a thyroid scintigram was performed in 25 patients with PHPT. During the thyroid scintigraphy sodium citrate was infused which lowered plasma calcium by a mean of 14 +/- 1.3%. Then 700 MBq (99m)Tc-sestamibi was injected and another scintigram of the neck was obtained. Perchlorate was given at the end of the sestamibi scintigram to increase the wash-out of (99m)Tc-pertechnetate from the thyroid gland, and after 2 h a delayed scintigram was obtained. A subtraction of the thyroid scintigram from the initial sestamibi scintigram was performed. The results of SPS and a conventional (99m)Tc-sestamibi dual-phase parathyroid scintigraphy were compared with the operative findings. In nine patients the parathyroid adenoma was also localized with ultrasound and the flow pattern before and after citrate infusion was visualized with Doppler technique. RESULTS: Eighty-eight per cent of the adenomas were localized correctly with the SPS technique compared with 62% at the conventional parathyroid scintigraphy. Tissue perfusion of the nine adenomas increased after citrate infusion. CONCLUSIONS: SPS has a high accuracy and it is easy to perform. If only subtraction SPS is performed the whole examination can be completed within an hour, which is acceptable for same day surgery. |
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Authors:
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Christina G Øgard; Henrik Vestergaard; Jørn B Thomsen; Henrik Jakobsen; Thomas Almdal; Steen L Nielsen |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical physiology and functional imaging Volume: 25 ISSN: 1475-0961 ISO Abbreviation: Clin Physiol Funct Imaging Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-05-12 Completed Date: 2005-09-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 101137604 Medline TA: Clin Physiol Funct Imaging Country: England |
Other Details:
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Languages: eng Pagination: 166-70 Citation Subset: IM |
Affiliation:
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Department of Clinical Physiology and Nuclear Medicine, Herlev University Hospital, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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radionuclide imaging*,
ultrasonography Chi-Square Distribution Female Humans Hyperparathyroidism / radionuclide imaging*, ultrasonography Hypocalcemia / radionuclide imaging*, ultrasonography Male Middle Aged Parathyroid Neoplasms / radionuclide imaging*, ultrasonography Radiopharmaceuticals / diagnostic use Sodium Pertechnetate Tc 99m / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 23288-60-0/Sodium Pertechnetate Tc 99m |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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