Preoperative Localization of Parathyroid Lesions in Hyperparathyroidism: Relationship Between Technetium-99m-MIBI Uptake and Oxyphil Cell Content

• Published in: The Journal of nuclear medicine (1978) Vol. 39; no. 8; pp. 1441 - 1444
• Main Authors: Carpentier, Andre, Jeannotte, Simon, Verreault, Jean, Lefebvre, Bernard, Bisson, Guy, Mongeau, Charles-Jacques, Maheux, Pierre
• Format: Journal Article
• Language: English
• Published: Reston, VA Soc Nuclear Med 01.08.1998; Society of Nuclear Medicine
• Subjects: Adenoma - diagnostic imaging; Adenoma - pathology; Adenoma, Oxyphilic - diagnostic imaging; Adenoma, Oxyphilic - pathology; Adult; Aged; Biological and medical sciences; Endocrinopathies; Female; Humans; Hyperparathyroidism - diagnostic imaging; Hyperparathyroidism - pathology; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Parathyroid Glands - diagnostic imaging; Parathyroid Glands - pathology; Parathyroid Neoplasms - diagnostic imaging; Parathyroid Neoplasms - pathology; Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases); Preoperative Care; Radionuclide Imaging; Radiopharmaceuticals; Retrospective Studies; Single-Blind Method; Technetium Tc 99m Sestamibi; Endocrinopathy; Radionuclide study; Human; Double scintigraphy; Retention; Mitochondria; Parathyroid diseases; Surgery; Distribution; Medical imagery; Lesion; Preoperative; Localization; Technetium(99mTc) sestamibi; Hyperparathyroidism
• ISSN: 0161-5505; 1535-5667

The aim of this study was to assess the relationship between parathyroid oxyphil cell content and early or late phases of uptake of 99mTc-MIBI, a radioisotope preferentially retained in mitochondria-rich cells. This study is a retrospective, single-blind analysis of all double-phase 99mTc-MIBI parathyroid scintigraphy studies performed before surgery in our institution between 1990 and 1995. A total of 18 parathyroid lesions in 14 patients were reviewed. This sample included 11 cases of primary hyperparathyroidism (8 adenomas, 1 adenocarcinoma and 2 hyperplasias) and 3 cases of tertiary hyperparathyroidism secondary to chronic renal failure. Uptake of 99mTc-MIBI in the early phase of scintigraphy was associated with larger parathyroid lesions (1.61 +/- 1.61 ml versus 0.33 +/- 0.27 ml; p < 0.02) and higher serum calcium levels (3.00 +/- 0.41 mM versus 2.67 +/- 0.14 mM; p < 0.02). More importantly, we found that a parathyroid oxyphil cell content greater than 25% was more often associated with a positive uptake of 99mTc-MIBI in the late phase of the test (positive late uptake in 78% of lesions with a high oxyphil cell content versus 33% in lesions with an oxyphil cell content between 1% and 25% and 0% in lesions with no oxyphil cells; p < 0.04). These findings suggest that the late retention of 99mTc-MIBI in double-phase scintigraphy is related to parathyroid oxyphil cell content.