[Value of 99mTc-MIBI scintigraphy in diagnostic localization of hyperparathyroidism. A prospective study]

We evaluated the sensitivity of praeoperative parathyroid imaging using 99mTc-MIBI scintigraphy in planar as well as SPECT technique to detect and localize abnormal parathyroid glands in 36 patients with hyperparathyroidism. Seven out of these patients had been previously operated in the thyroid area. With a sensitivity of 76% (22/29) solid adenomas could be localized correctly. Surgical success was estimated by the weight of the adenomas, by histology and postoperative laboratory findings. Compared to other imaging procedures 99mTc-MIBI-scintigraphy seems to be most sensitive in detecting and localizing abnormal parathyroid glands, especially in previously operated patients. Praeoperative standard in nuclear medicine up to now is Tl-Tc-subtraction scintigraphy, which is technically more difficult, sensitive to artefacts and exposes the patient to more radiation. Based on our experience we would therefore suggest to screen all previously operated patients with 99mTc-MIBI scintigraphy on a routine basis.