Document Detail


Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism.
MedLine Citation:
PMID:  15888097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Christina G Øgard; Henrik Vestergaard; Jørn B Thomsen; Henrik Jakobsen; Thomas Almdal; Steen L Nielsen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical physiology and functional imaging     Volume:  25     ISSN:  1475-0961     ISO Abbreviation:  Clin Physiol Funct Imaging     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-12     Completed Date:  2005-09-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101137604     Medline TA:  Clin Physiol Funct Imaging     Country:  England    
Other Details:
Languages:  eng     Pagination:  166-70     Citation Subset:  IM    
Affiliation:
Department of Clinical Physiology and Nuclear Medicine, Herlev University Hospital, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / 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:
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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