Nephrology Dialysis Transplantation, Vol 12, Issue 1 97-100, Copyright © 1997 by Oxford University Press
A Chesser, M Carroll, C Lightowler, I Macdougall, K Britton and L Baker
Background. Technetium-99m methoxy isobutyl isonitrile
(Tc-99m MIBI) scintigraphy has been reported to be at least as reliable as
thallium-technetium subtraction imaging in the preoperative localization of
hyperplastic parathyroid glands in patients with renal failure. Reports
have suggested that 50% of glands can be identified correctly by this
method. The aim of this study was to improve on previous results and
demonstrate that Tc-99m MIBI imaging has an important place in the
preoperative work-up of these patients. Methods.
Eighteen patients on renal replacement therapy were studied. All had
tertiary hyperparathyroidism and had Tc-99m MIBI imaging prior to
parathyroidectomy. A refined reporting method was employed. The imaging
results were compared to the subsequent surgical and histological findings.
Results. In the 12 patients in whom serum parathyroid
hormone levels fell postoperatively to within or below the normal range, 38
of 46 glands (82.6%) were correctly identified and located in the correct
quadrant of the thyroid gland. There were two false positive results where
the imaging predicted glands not subsequently found by the surgeon. In the
patients who had post-operative hyperparathyroidism, repeat Tc-99m MIBI
imaging was able to locate accurately the site of the residual parathyroid
tissue. Conclusion. Tc-99m MIBI imaging is able to
identify more than 80% of hyperplastic parathyroid glands in renal failure
patients if this reporting process is used, and locate them in the correct
quadrant of the thyroid gland. Tc-99m MIBI imaging is of particular value
when re-exploration of the neck is required for post-parathyroidectomy
hyperparathyroidism. These results represent a significant improvement on
the sensitivity of this imaging technique when compared to previous
published data. Keywords: hyperplasia; imaging,
parathyroid; renal failure, technetium-99m methoxy isobutyl isonitrile
ORIGINAL ARTICLES
Technetium-99m methoxy isobutyl isonitrile (MIBI) imaging of the parathyroid glands in patients with renal failure
Departments of Nephrology and Nuclear Medicine, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK; Corresponding author
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. R. Neumann, C. B. Esselstyn Jr., A. Madera, C. O. Wong, and M. Lieber Parathyroid Detection in Secondary Hyperparathyroidism with 123I/99mTc-Sestamibi Subtraction Single Photon Emission Computed Tomography J. Clin. Endocrinol. Metab., November 1, 1998; 83(11): 3867 - 3871. [Abstract] [Full Text]
|
|