Parathyroid Scan

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Indication:

• Localisation of suspected parathyroid adenoma. It is not a screening test for hyperparathyroidism.

Principle:

• Sestamibi is actively taken up by parathyroid adenomata and has a slow washout from these lesions compared to normal parathyroid tissue. The scan is normally done in conjunction with a technetium thyroid scan because thyroid adenomas may also show increased retention of Sestamibi.

Preparation and Procedure:

• The technetium thyroid scan is usually performed 2 – 3 days before the parathyroid study.

• Parathyroid scans involve early and late acquisitions over a period of 2.5 hours.

Comments:

• 99mTc-Sestamibi parathyroid imaging can be useful in the preoperative detection and localisation of parathyroid adenomas in patients having proven hyperparathyroidism (sensitivity of 90%). SPECT/CT provides topographic correlation with adjacent anatomical structures; this imaging technique can identify a single adenoma, multiple adenomas, ectopic adenomas or hyperplastic glands.