HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Eslamy, H. K. Articles by Ziessman, H. A. PubMed PubMed Citation Articles by Eslamy, H. K. Articles by Ziessman, H. A. Related Collections Nuclear Medicine Computed Tomography Gastrointestinal Radiology

Parathyroid Scintigraphy in Patients with Primary Hyperparathyroidism: ^99mTc Sestamibi SPECT and SPECT/CT¹

¹ From the Division of Nuclear Medicine, the Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, 601 N Caroline St, Suite 3231, Baltimore, MD 21278. Presented as an education exhibit at the 2006 RSNA Annual Meeting. Received March 26, 2007; revision requested July 25; final revision received February 15, 2008, and accepted February 20. All authors have no financial relationships to disclose. Address correspondence to H.A.Z. (e-mail: hziessm1{at}jhmi.edu).

The clinical diagnosis of primary hyperparathyroidism is based largely on serum laboratory test results, as patients often are asymptomatic. Surgery, often with bilateral exploration of the neck, has been considered the definitive treatment for symptomatic disease. However, given that approximately 90% of cases are due to a single parathyroid adenoma, a better treatment may be the selective surgical excision of the hyperfunctioning parathyroid gland after its preoperative identification and localization at radiologic imaging. Scintigraphy and ultrasonography are the imaging modalities most often used for preoperative localization. Various scintigraphic protocols may be used in the clinical setting: Single-phase dual-isotope subtraction imaging, dual-phase single-isotope imaging, or a combination of the two may be used to obtain planar or tomographic views. Single photon emission computed tomography (SPECT) with the use of technetium-99m (^99mTc) sestamibi as the radiotracer, especially when combined with x-ray–based computed tomography (CT), is particularly helpful for preoperative localization: The three-dimensional functional information from SPECT is fused with the anatomic information obtained from CT. In addition, knowledge of the anatomy and embryologic development of the parathyroid glands and the pathophysiology of primary hyperparathyroidism aid in the identification and localization of hyperfunctioning glands.

© RSNA, 2008