[Use of 99mTc-tetrofosmin scintigraphy in the diagnosis of patients with hyperparathyroidism]

The aim of the work was to study the diagnostic value of 99mTc-tetrofosmin to localize anomalous parathyroid glands in patients with hyperparathyroidism.

We have studied 33 patients: 12 with primary and 21 with secondary hyperparathyroidism, 9 of them renal graft recipients. Sixteen patients underwent surgery, 12 with primary and 4 with secondary hyperparathyroidism. All patients were injected with 740 MBq of 99mTc-tetrofosmin. Subsequently at 15, 30 and 60 minutes images were acquired for 300 seconds using a pin-hole collimator. A pertechnetate thyroid scintigraphy was obtained in 7 cases (24-48 h later) when the thyroid activity made difficult the identification of parathyroid glands.

In the group of patients with primary hyperparathyroidism, all cases showed a focal uptake in lower right localization. In the secondary hyperparathyroidism group, 12 patients showed diffuse tracer uptake in two or more glands and histology confirmed hyperplasia in four of them. Seven cases showed a greater focal uptake in a gland: two of them were renal graft recipients and three were chronic renal failure cases in haemodyalisis, and two were evaluated postsurgery showing uptake in the remnant parathyroid gland. The two remaining patients had a normal scintigraphy and corresponded to two false negative cases. In conclusion, our results suggest that 99Tc-tetrofosmin may be used as a suitable tracer for preoperative detection and screening of anomalous parathyroid glands.