Parathyroid scintigraphy with Tc99m sestamibi

Background: Parathyroid scintigraphy with Tc99m Sestamibi, a tracer that is taken up by hyperfunctioning parathyroid tissue, has a high yield in the diagnosis of abnormal parathyroid growths. Aim: To assess the usefulness of parathyroid scintigraphy with Tc99m Sestamibi in patients with suspected hyperparathyroidism. Patients and methods: We analyzed retrospectively 29 patients with suspected hyperparathyroidism, in whom a scintigraphy with Tc99m Sestamibi was performed. Results: Twenty four of 25 patients in whom hyperfunctioning parathyroid tissue was evidenced with scintigraphy, were operated. Histological diagnosis of the excised parathyroid gland, showed 23 adenomas and 1 hyperplasia. Anatomical location disclosed by scintigraphy was concordant with surgical findings in all cases, including a mediastinic adenoma. Of the four patients with negative scintigraphic findings, two had transitory PTH elevations and in two the presence of adenoma or hyperplasia could not be demonstrated with other diagnostic procedures. Conclusions: Parathyroid scintigraphy with Tc99m Sestamibi had an 86% sensitivity for the detection of hyperfunctioning parathyroid tissue in patients with elevated PTH.