Localization of parathyroid glands using technetium-99m-tetrofosmin imaging

Area of Science:

• Nuclear Medicine
• Endocrinology
• Radiology

Background:

• Preoperative localization of hyperactive parathyroid glands is crucial for minimizing surgical time and patient morbidity.
• Accurate localization aids in planning and executing successful parathyroidectomy.

Purpose of the Study:

• To compare the sensitivity of radionuclide imaging with technetium-99m (99mTc) tetrofosmin against ultrasonography and magnetic resonance (MR) imaging for localizing abnormal parathyroid glands in patients with hyperparathyroidism.

Main Methods:

• 26 patients with primary or secondary hyperparathyroidism underwent imaging using 99mTc tetrofosmin, ultrasound, and MR imaging.
• Parathyroid lesions were localized in the neck and thorax.
• Imaging results were correlated with pathological findings in 18 patients who underwent parathyroidectomy.

Main Results:

• 99mTc tetrofosmin imaging demonstrated focal uptake in 46 glands, with successful localization of 100% of adenomas and 73% of hyperplastic glands.
• The sensitivity for localizing abnormal glands was 77.3% for 99mTc tetrofosmin, 68.2% for ultrasonography, and 68.2% for MR imaging.
• 99mTc tetrofosmin imaging exhibited higher sensitivity compared to ultrasonography and MR imaging.

Conclusions:

• 99mTc tetrofosmin parathyroid imaging is a valuable tool for localizing abnormal glands in both primary and secondary hyperparathyroidism.
• Its high sensitivity surpasses that of ultrasonography and MR imaging, offering improved preoperative localization.
• The retention of tetrofosmin does not appear to be directly dependent on the number of mitochondria-rich oxyphil cells.