Correlation between serum calcium levels and dual-phase 99mTc-sestamibi parathyroid scintigraphy in primary hyperparathyroidism

2011 ◽  
Vol 32 (1) ◽  
pp. 19-24 ◽  
Author(s):  
D. S. Mshelia ◽  
A. N. Hatutale ◽  
N. P. Mokgoro ◽  
M. E. Nchabaleng ◽  
J. R. Buscombe ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Dual Phase ◽  
Parathyroid Scintigraphy ◽  
99Mtc Sestamibi

scholarly journals Renal Manifestation in Patients with Primary Hyperparathyroidism: a Retrospective Analysis in a Tertiary Institute

2018 ◽  
Vol 20 (1) ◽  
pp. 32
Author(s):  
Shamim MF Begum ◽  
Nasreen Sultana ◽  
Rahima Parveen ◽  
Khaled Bin Shamsuddin ◽  
Md Bashir ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Renal Stone ◽  
Control Group ◽  
Dual Phase ◽  
Renal Manifestation ◽  
Group I ◽  
Sestamibi Scan ◽  
Study Population ◽  
Group Ii ◽  
99Mtc Sestamibi

<p><strong>Objectives:</strong> The classical renal manifestations of primary hyperparathyroidism (PHPT) are nephrolithiasis and nephrocalcinosis. The presence of renal stone categorizes PHPT as symptomatic variant. The clinical profile of PHPT has changed in past few decades with decreased prevalence of renal stone disease with the introduction of widespread routine biochemical screening in normal subjects. In developing countries, PHPT is still a late diagnosed disorder and most of the patients are symptomatic at presentation. Presence of renal stone in PHPT patients is an absolute indication of parathyroidectomy, hence it is important to identify renal involvement in PHPT. The objective of the study is to determine the rate of renal manifestations in patients of biochemically primary hyperparathyroidism and compared to control group. This retrospective review was performed to determine whether the rate of nephrolithiasis and nephrocalcinosis is still high in the patients who underwent dual phase 99mTc sestamibi scan for PHPT at National Institute of Nuclear Medicine and Allied Sciences (NINMAS) compared to those not affected by the disorder.</p><p><strong>Patients and Methods:</strong> A total 149 patients (male 72 and female   77) and mean age 41 ± 14.73 years with PHPT were included in this study. All patients underwent dual phase 99mTc sestamibi parathyroid scan. Result of 99mTc sestamibi scan were divided into two groups. Group I represented positive scan and group II indicated negative scan respectively.Relevant clinical history, biochemical values including serum calcium level, serum parathormone (PTH) level and data on renal manifestations were recorded. The control group comprised of 650 subjects who had abdominal ultrasonography for various clinical conditions without any history of PHPT. Renal manifestations were compared between PHPT patients and the control group.</p><p><strong>Results:</strong> Among 149 patients, scan was positive in 54(36.2%) cases (group I) and scan was negative in 95(63.8%) cases (group II). In group I, renal manifestations were present in 20 cases and   absent in 34 cases. In group II, renal manifestations were present in 32 cases and were absent in 63 cases. Nephrolithiasis and nephrocalcinosis were present in 45(30.2%) and 7(4.7%) cases respectively in study population compared to 8(1.23%) persons of control group of 650 subjects. Pearson’s chi-square analysis showed that the difference in the rate of renal manifestations was significant (p &lt; 0.001) between study population and control group. However, with in the study population the rate of renal manifestations between group I and group II was not significantly different (p = 0.137).</p><p><strong>Conclusion:</strong> This study showed eighteen fold increased renal manifestations in the patients with PHPT imaged for parathyroid gland compared to the subjects not affected by the disorder. Symptomatic variant of PHPT with renal manifestation was higher in this study compared to western countries. During parathyroid scanning in PHPT routine ultrasonographic evaluation of kidneys is necessary to exclude renal manifestation, even with negative parathyroid scan.</p><p>Bangladesh J. Nuclear Med. 20(1): 32-36, January 2017</p>

Dual-Phase 99mTc Sestamibi Scintigraphy With Neck and Thorax SPECT/CT in Primary Hyperparathyroidism

2012 ◽  
Vol 37 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Renaud Ciappuccini ◽  
Julia Morera ◽  
Pierre Pascal ◽  
Jean-Pierre Rame ◽  
Natacha Heutte ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Dual Phase ◽  
Sestamibi Scintigraphy ◽  
99Mtc Sestamibi

scholarly journals Complex management decisions in a woman with concurrent primary hyperparathyroidism and metastatic papillary thyroid carcinoma, both presenting during pregnancy

2019 ◽  
Vol 2019 ◽  
Author(s):  
Lorena Arnez ◽  
Victor Lawrence
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Primary Hyperparathyroidism ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Surgical Management ◽  
Serum Calcium ◽  
Neck Exploration ◽  
Parathyroid Scintigraphy ◽  
Papillary Thyroid ◽  
Remnant Ablation

Summary A 40-year-old woman was hospitalised at 25-week gestation following a diagnosis of severe symptomatic hypercalcaemia (adjusted serum calcium 3.02 mmol/L). A diagnosis of primary hyperparathyroidism (PHP) was made on the basis of elevated parathyroid hormone (PTH) 11.2 pmol/L (reference range 1.5–6.9) and exclusion of familial hypocalciuric hypercalcaemia. Ultrasound examination of the neck did not convincingly demonstrate an abnormal or enlarged parathyroid gland and parathyroid scintigraphy was not performed due to maternal choice relating to perceived radiation risk to the foetus. At neck exploration during the 28th week of pregnancy a right lower pole parathyroid lesion was excised together with two abnormal lymph nodes (largest 1.6 cm). Histology confirmed a parathyroid adenoma and also papillary thyroid carcinoma deposits in the two resected lymph nodes. Post-operatively, levels of adjusted serum calcium normalised and pregnancy progressed uneventfully to term. Total thyroidectomy was performed 2 weeks after delivery revealing two small foci of papillary micro-carcinoma (largest 2.3 mm, one in each thyroid lobe) with no evidence of further metastatic tumour in lymph nodes removed during functional neck dissection. Radioiodine remnant ablation (RRA) was performed 2 months post thyroidectomy to allow for breast involution. The patient remains in full clinical and biochemical remission 9 years later. We present and review the difficult management decisions faced in relation to the investigation and treatment of PHP in pregnancy, further complicated by incidentally discovered locally metastatic pT1aN1aM0 papillary thyroid carcinoma. Learning points: PHP may have serious consequences during pregnancy and usually requires surgical management during pregnancy to reduce the risk of maternal and foetal complications. The indications for and optimal timing of surgical management are discussed. Localisation by parathyroid scintigraphy is controversial during pregnancy: modified dose regimes may be considered in preference as an alternative to unguided neck exploration. Breastfeeding is contraindicated for 6–8 weeks before radioactive-iodine remnant ablation (RRA) to prevent increased breast uptake. Breastfeeding is further contra-indicated until after a subsequent pregnancy. Incidentally discovered differentiated thyroid carcinoma (DTC) in cervical lymph nodes in some cases may be managed expectantly because in one quarter of thyroidectomies the primary tumour remains occult.

scholarly journals Evaluation of the Radiological Findings of the Patints Having Surgical Intervention For The Primary Hyperparathyroidism

2021 ◽  
Author(s):  
Uğur Kalan ◽  
Ferhat Gökay
Keyword(s):  
Primary Hyperparathyroidism ◽  
Surgical Intervention ◽  
Demographic Data ◽  
Diagnostic Sensitivity ◽  
Histopathological Diagnosis ◽  
Dual Phase ◽  
Parathyroid Scintigraphy ◽  
Diagnostic Significance ◽  
Parathyroid Adenomas ◽  
Diagnostic Sensitivity And Specificity

Objective: In this study, we aimed to compare the results of ultrasonography and Tc-99m sestamibi dual phase parathyroid scintigraphy with postoperative pathology findings in patients with primary hyperparathyroidism. Methods: The study was carried out with 96 patients, who had surgical intervention for primary hyperparathyroidism and followed up in the Endocrinology and Metabolism Clinic, between January 2010-December 2015. Demographic data and preoperative laboratory results of the patients were reviewed. Diagnostic accuracy and compliance were calculated by comparing imaging methods with surgical localization and histopathological evaluation results. Results: Parathyroid adenomas were detected in 75, parathyroid hyperplasia in 12, and parathyroid carcinoma in 5 and suspect pathology results in 4 patients. The mean preoperative calcium (11.25 mg/dl) and parathormone (400.06 pg/ml) levels were determined. Ultrasonography had an estimated diagnostic sensitivity of 58.7% and a specificity of 38.5% in cases with parathyroid adenoma. It was observed that ultrasonography has not any diagnostic significance, and it is not in accordance with histopathological diagnosis (Kappa=-0.018, p=0.851). Diagnostic sensitivity, and specificity of scintigraphy were found to be 58.7%, and 38.5%, respectively. It was observed to be only fairly concordant, and significant according to histopathological diagnosis (Kappa=0.221, p=0.047). Conclusion: Tc-99m MIBI dual-phase parathyroid scintigraphy, a highly sensitive and noninvasive imaging technique, is clearly superior to the ultrasonography in detecting parathyroid adenomas and locating regions correctly.

Increasing the radiochemical purity of 99mTc sestamibi commercial preparations results in improved sensitivity of dual-phase planar parathyroid scintigraphy

2005 ◽  
Vol 26 (12) ◽  
pp. 1093-1098 ◽  
Author(s):  
Maroun Karam ◽  
Raymond N. Dansereau ◽  
Charles J. Dolce ◽  
Paul J. Feustel ◽  
Lawrence W. Robinson
Keyword(s):  
Radiochemical Purity ◽  
Dual Phase ◽  
Parathyroid Scintigraphy ◽  
99Mtc Sestamibi
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