The American Journal of Surgery
Volume 199, Issue 5 , Pages 614-620 , May 2010

Determinants of Tc-99m sestamibi SPECT scan sensitivity in primary hyperparathyroidism

  • Todd W. Swanson, M.D.

      Affiliations

    • Department of Surgery, St Paul's Hospital & University of British Columbia, Vancouver, BC, Canada
    • ,
  • Simon K. Chan, M.S.

      Affiliations

    • Department of Medical Genetics, University of British Columbia, British Columbia Cancer Agency and Michael Smith Genome Sciences Center, Vancouver, BC, Canada
    • ,
  • Steven J. Jones, Ph.D.

      Affiliations

    • Department of Medical Genetics, University of British Columbia, British Columbia Cancer Agency and Michael Smith Genome Sciences Center, Vancouver, BC, Canada
    • ,
  • Samuel Bugis, M.D., F.R.C.S.C.

      Affiliations

    • Department of Surgery, St Paul's Hospital & University of British Columbia, Vancouver, BC, Canada
    • ,
  • Robert Irvine, M.D., F.R.C.S.C.

      Affiliations

    • Department of Surgery, St Paul's Hospital & University of British Columbia, Vancouver, BC, Canada
    • ,
  • Allan Belzberg, M.D., F.R.C.P.C.

      Affiliations

    • Department of Nuclear Medicine, St Paul's Hospital & University of British Columbia, Vancouver, BC, Canada
    • ,
  • Daniel Levine, M.B.Ch.B., M.R.C.P., F.R.C.R., F.R.C.P.C.

      Affiliations

    • Department of Nuclear Medicine, St Paul's Hospital & University of British Columbia, Vancouver, BC, Canada
    • ,
  • Sam M. Wiseman, M.D., F.R.C.S.C.

      Affiliations

    • Department of Surgery, St Paul's Hospital & University of British Columbia, Vancouver, BC, Canada
    • Corresponding Author InformationCorresponding author. Tel.: 604-806-9108; fax: 604-806-9957

Received 3 November 2009 ,Revised 4 February 2010

References 

  1. Consensus Development Conference Panel. Diagnosis and management of asymptomatic primary hyperparathyroidism: consensus development conference statement. Ann Intern Med. 1991;114:593–597
  2. Coakley AJ, Kettle AG, Wells CP, O'Doharty MJ, Collins REC. 99m Tc-sestamibi—a new agent for parathyroid imaging 1989. Nucl Med Commun. 1989;10:791–794
  3. Casas AT, Burke GJ, Arlie R, Mansberger J, Wei JP. Impact of technetium-99m-sestamibi localization on operative time and success of operations for primary hyperparathyroidism. Am Surg. 1994;60:12–16
  4. Sebag F, Hubbard JG, Maweja S, Misso C, Tardivet L, Henry JF. Negative preoperative localization studies are highly predictive of multiglandular disease in sporadic primary hyperparathyroidism. Surgery. 2003;134:1038–1041
  5. Chiu B, Sturgeon C, Angelos P. What is the link between nonlocalizing sestamibi scans, multigland disease, and persistent hypercalcemia? (A study of 401 consecutive patients undergoing parathyroidectomy). Surgery. 2006;140:418–422
  6. O'Doherty MJ, Kettle AG, Wells P, Collins REC, Coakley AJ. Parathyroid imaging with technetitum-99m-sestamibi: preoperative localization and tissue uptake studies. J Nucl Med. 1992;33:313–318
  7. Erbil Y, Kapran Y, Issever H, et al. The positive effect of adenoma weight and oxyphil cell content on preoperative localization with 99mTc-sestamibi scanning for primary hyperparathyroidism. Am J Surg. 2008;195:34–39
  8. Pons F, Torregrosa IV, Fuster D. Biologic factors influencing parathyroid localization. Nucl Med Commun. 2003;24:121–124
  9. Fuster D, Ybarra J, Torregrosa JV, et al. Double-phase parathyroid 99m Tc-sestamibi scintigraphy in chronic hemodialysis patients: correlation with biochemical markers of parathyroid function. Nucl Med Commun. 2003;24:85–90
  10. Royal RE, Delpassand ES, Shapiro SE, et al. Improving the yield of preoperative parathyroid localization: technetium 99m-sestamibi imaging after thyroid suppression. Surgery. 2002;132:968–974
  11. Gotthardt M, Lohmann B, Behr TM, et al. Clinical value of parathyroid scintigraphy with technetium-99m methoxyisobutylisonitrile: discrepancies in clinical data and a systematic metaanalysis of the literature. World J Surg. 2004;28:100–107
  12. Hetrakul N, Civelek C, Stagg CA, Udelsman R. In vitro accumulation of technetium-99m-sestamibi in human parathyroid mitochondria. Surgery. 2001;130:1011–1018
  13. Mitchell BK, Cornelius EQ, Zoghbi S, Kinder BK. Mechanism of technetium 99m sestamibi parathyroid imaging and the possible role of p-glycoprotein. Surgery. 1996;120:1039–1046
  14. Yamaguchi S, Yachiku S, Hashimoto HW. Relationship between technetium 99m-methoxyisobutylisonitrile and the multidrug resistant protein in parathyroid glands. J Surg. 2002;26:29–34
  15. Shiau YC, Tsai SC, Wang JJ, Ho ST, Kao A. Detecting parathyroid adenoma using technetium-99m tetrofosmin: comparison with P-glycoprotein and multidrug resistance related protein expression-a preliminary report. Nucl Med Biol. 2002;29:339–344
  16. Huang WE. Size and p-glycoprotein expression limit 99mTc-tetrofosmin uptake in parathyroid adenoma. Nucl Med Commun. 2002;23:1001–1004
  17. Ballinger JR, Hua HA, Berry BW, Birby P, Boxen I. 99Tcm-sestamibi as an agent for the imaging P-glycoprotein-mediated multi-drug resistance: in vitro and in vivo studies in a rat breast tumour cell line and its doxorubicin-resistant variant. Nucl Med Commun. 1995;16:253–257
  18. Pariante CM. The role of multi-drug resistance p-glycoprotein in glucocorticoid function: studies in animals and relevance in humans. Eur J Pharmacol. 2008;583:263–271
  19. Patrignani P, Tacconelli S, Sciulli MG, Capone ML. New insights into COX-2 biology and inhibition. Brain Res Rev. 2005;48:352–359
  20. Arbab AS, Koizumi K, Toyama K, Arai T, Araki T. Effects of ion channel modulators in the infux and efflux of Tc-99m-MI. Ann Nucl Med. 1999;13:27–32
  21. Arbab AS, Ueki J, Koisumi K, Araki T. Effects of extracellular Na+ and Ca2+ ions and Ca2+ channel modulators on the cell-associated activity of 99mTc-MIBI and 99mTc-tetrofosmin in tumour cells. Nucl Med Commun. 2003;24:155–166
  22. Friedman K, Somervell H, Patel P, et al. Effect of calcium channel blockers on the sensitivity of preoperative 99m Tc-MIBI SPECT for hyperparathyoidims. Surgery. 2004;136:1199–1204
  23. MacQueen JB. Some methods for classification and analysis of multivariate observations. Proc 5th Berkeley Symp Math Statist Prob. 1967;1:281–297
  24. Han J, Kamber M. Data Mining: Concepts and Techniques. New York: Morgan Kaufmann; 2001;
  25. Pavlidis P, Noble WS. Matrix2png: a utility for visualizing matrix data. Bioinformatics. 2003;19:295–296
  26. Bandeira FA, Oliveira RI, Griz LH, Caldas G, Bandeira C. Differences in accuracy of 99mTc-sestamibi scanning between severe and mild forms of primary hyperparathyroidism. J Nucl Med Technol. 2008;36:30–35
  27. Sywak MS, Knowlton ST, Pasieka JL, Parsons LL, Jones J. Do the National Institutes of Health consensus guidelines for parathyroidectomy predict symptom severity and surgical outcome in patients with primary hyperparathyroidism?. Surgery. 2002;132:1013–1019

 This work was supported by the Michael Smith Foundation for Health Research (Vancouver, BC, Canada). Dr Wiseman is a Michael Smith Foundation for Health Research Scholar.

PII: S0002-9610(10)00051-6

doi: 10.1016/j.amjsurg.2010.02.001

The American Journal of Surgery
Volume 199, Issue 5 , Pages 614-620 , May 2010

Article Tools

* Image Usage & Resolution