Two-phase scintigraphy with technetium 99m–sestamibi in patients with hyperparathyroidism due to chronic renal failure

Muros, Maria A.; Soto, Juan Bravo; López Ruiz, José M.; Rodríguez-Portillo, Mariano; Ramírez Navarro, Angel; Bellón Guardia, María; Perán, Fernando; Llamas-Elvira, Jose M.

doi:10.1016/j.amjsurg.2006.08.078

« Previous Next »The American Journal of Surgery
Volume 193, Issue 4 , Pages 438-442, April 2007

Two-phase scintigraphy with technetium 99m–sestamibi in patients with hyperparathyroidism due to chronic renal failure

Maria A. Muros, Ph.D.
- Department of Nuclear Medicine, Hospital Virgen de las Nieves, Granada, Spain
- Corresponding author. Servicio de Medicina Nuclear, Hospital Virgen de las Nieves, Avda. Fuerzas Armadas 2, 18014 Granada, Spain. Tel.: +34 958 020580/020110; fax: +34 958 020179.
Juan Bravo Soto, Ph.D.
- Department of Nephrology, Hospital Virgen de las Nieves, Granada, Spain
José M. López Ruiz, Ph.D.
- Department of Nuclear Medicine, Hospital Virgen de las Nieves, Granada, Spain
Mariano Rodríguez-Portillo, Ph.D.
- Department of Clinical Pathology, Hospital Reina Sofia, Cordoba, Spain
Angel Ramírez Navarro, Ph.D.
- Department of Nuclear Medicine, Hospital Virgen de las Nieves, Granada, Spain
María Bellón Guardia, M.D.
- Department of Nuclear Medicine, Hospital Virgen de las Nieves, Granada, Spain
Fernando Perán, Ph.D.
- Laboratory Medicine Department, Hospital Virgen de las Nieves, Granada, Spain
Jose M. Llamas-Elvira, Ph.D.
- Department of Nuclear Medicine, Hospital Virgen de las Nieves, Granada, Spain

Received 28 March 2006; received in revised form 2 August 2006

Abstract

Background

The objective of the current study was to study different functional and anatomic features of the hyperplastic gland and clinical and biochemical characteristics of renal hyperparathyroidism (HPT) patients and their relationship with the scintigraphic detection of parathyroid glands.

Methods

A retrospective study was performed of 40 patients with chronic renal failure (CRF) who underwent cervical surgery for HPT. Weight, histology, and localization of hyperplastic glands were recorded. Parathyroid cell proliferation was assessed by percentage of S-phase cells. Double-phase scintigraphy with technetium 99m–sestamibi and serum parathyroid intact hormone (PTHi), creatinine, calcium, and phosphate levels were performed.

Results

Detection of hyperplastic parathyroid glands by ^99mTc-sestamibi scintigraphy was associated with the weight and inferior localization of the glands. The functionality of the glands as reflected in serum PTHi and phosphorus levels was associated with the number of glands detected.

Conclusion

Double-phase ^99mTc-sestamibi scintigraphy is of limited usefulness in patients with renal HPT. Detection of hyperplastic parathyroid glands in patients with CRF depends on the weight and inferior localization of the glands. Serum PTHi, phosphorus and creatine levels are associated with the number of glands detected by means of ^99mTc-sestamibi scintigraphy.

Keywords: Parathyroid gland hyperplasia, Renal hyperparathyroidism, Sestamibi scintigraphy