Parathyroid scintigraphy: first experiences with technetium (III)-99m-Q12

Area of Science:

• Nuclear Medicine
• Radiopharmacology
• Endocrinology

Background:

• Hyperparathyroidism diagnosis often relies on imaging to locate parathyroid adenomas.
• Current scintigraphic agents like sestamibi (MIBI) and tetrofosmin have limitations in sensitivity and thyroid retention.
• Novel radiotracers are needed to improve parathyroid adenoma detection.

Purpose of the Study:

• To evaluate the preliminary efficacy of technetium-99m furifosmin (Q12) for parathyroid scintigraphy.
• To compare the uptake and retention characteristics of Q12 in parathyroid adenomas versus thyroid tissue.
• To assess the sensitivity of Q12 in identifying histologically confirmed parathyroid adenomas.

Main Methods:

• Prospective study involving 12 patients with hyperparathyroidism.
• Administered technetium-99m furifosmin (Q12) and performed scintigraphy.
• Analyzed tracer retention half-times in parathyroid adenomas and thyroid gland.

Main Results:

• Q12 correctly identified parathyroid adenomas in 10 out of 12 patients, showing focal prolonged tracer retention.
• Retention half-times were longer in adenomas (mean 1.27 h) than in the thyroid gland (mean 1.05 h).
• In two patients where Q12 did not localize, surgical identification of adenomas was also unsuccessful.

Conclusions:

• Technetium-99m furifosmin (Q12) is a feasible and sensitive tracer for parathyroid scintigraphy.
• Q12 demonstrates advantageous short retention in the thyroid gland compared to MIBI and tetrofosmin.
• Further studies are required to compare Q12's sensitivity for small adenomas and its correlation with endocrine activity against existing agents.