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Differences in Accuracy of ^99mTc-Sestamibi Scanning Between Severe and Mild Forms of Primary Hyperparathyroidism

¹ Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Brazil; ² Division of Endocrinology, University of Pernambuco Medical School, Recife, Brazil; and ³ Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, Dilab Laboratories, Recife, Brazil

View larger version (100K): [in this window] [in a new window]   FIGURE 1.  99mTc-Sestamibi scan of patient with osteitis fibrosa cystica (group III): early (A) and delayed (B) images of right inferior parathyroid adenoma (arrows) weighing 6.5 g before initial surgery.

View larger version (62K): [in this window] [in a new window]   FIGURE 2.  99mTc-Sestamibi scan of patient with osteitis fibrosa cystica (group III). (A) Initial image, obtained 5 min after intravenous injection of 99mTc-sestamibi, shows increased uptake in parathyroid gland. (B) Delayed image, obtained at 2 h, shows right inferior parathyroid adenoma weighing 12 g before initial surgery.

View larger version (14K): [in this window] [in a new window]   FIGURE 3.  Comparison of 99mTc-sestamibi scans of parathyroid among the 3 clinical groups of PHPT at 5 min (early phase) and 2 h (delayed phase). Accuracy of technique increases in more severely affected patients, approaching 100%. Of patients with severe bone disease (group III), 70% showed increased uptake on early images, in contrast to patients in the other groups, who showed increased uptake only on delayed images.