Comparison between MIBI-based radiopharmaceuticals for parathyroid scintigraphy: quantitative evaluation and correlation with clinical-laboratory parameters

Maccora, Daria; Fortini, Daniela; Moroni, Rossana; Sprecacenere, G; Annunziata, Salvatore; Bruno, Isabella

doi:10.1007/s40618-022-01847-x

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…A 99m-Tc radiotracer may be administered via injection (intravenously) or orally and it may also be used for thyroid scintigraphy (sodium pertechnetate), both for adults (1-10 mCi) and children (60-80 µCi/kg). Increased homogeneous tracer uptake is suggestive for thyroid/parathyroid tissue in dual scintigraphy (sestamibi and pertechnetate), mostly depending on the uptake timing (early for thyroid and late/delayed for parathyroid at the moment when thyroid images are already washed out) [24].…”

Section: Imaging Pitfalls In Phpmentioning

confidence: 99%

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Carsote,

Stanciu,

Popa

et al. 2023

Medicina

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Diagnosis of primary hyperparathyroidism (PHP) is based on blood assessments in terms of synchronous high calcium and PTH (parathormone), but further management, particularly parathyroid surgery that provides the disease cure in 95–99% of cases, requires an adequate localisation of the parathyroid tumour/tumours as the originating source, with ultrasound and 99m-Technetium (99m-Tc) sestamibi scintigraphy being the most widely used. We aimed to introduce an adult female case diagnosed with PHP displaying unexpected intra-operatory findings (ectopic thyroid tissue) in relation to concordant pre-operatory imaging modalities (ultrasound + dual-phase 99m-Tc pertechnetate and sestamibi scintigraphy + computed tomography) that indicated bilateral inferior parathyroid tumours. A sudden drop in PTH following the removal of the first tumour was the clue for performing an extemporaneous exam for the second mass that turned out to be non-malignant ectopic thyroid tissue. We overviewed some major aspects starting from this case in point: the potential pitfalls of pre-operatory imaging in PHP; the concordance/discordance of pre-parathyroidectomy localisation modalities; the need of using an additional intra-operatory procedure; and the clues of providing a distinction between pathological parathyroids and thyroid tissue. This was a case of adult PHP, whereas triple localisation methods were used before parathyroidectomy, showing concordant results; however, the second parathyroid adenoma was a false positive image and an ectopic thyroid tissue was confirmed. The pre-operatory index of suspicion was non-existent in this patient. Hybrid imaging modalities are most probably required if both thyroid and parathyroid anomalies are suspected, but, essentially, awareness of the potential pitfalls is mandatory from the endocrine and surgical perspectives. Current gaps in imaging knowledge to guide us in this area are expected to be solved by the significant progress in functional imaging modalities. However, the act of surgery, including the decision of a PTH assay or extemporaneous exam (as seen in our case), represents the key to a successful removal procedure. Moreover, many parathyroid surgeons may currently perform 4-gland exploration routinely, precisely to avoid the shortcomings of preoperative localisation.

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Section: Imaging Pitfalls In Phpmentioning

confidence: 99%

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Carsote,

Stanciu,

Popa

et al. 2023

Medicina

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“…Radiopharmaceuticals are prepared to target specific organs, tissues, or cells, which allows for more accurate diagnosis and/or treatment. In nuclear medicine, the radiopharmaceuticals are used to produce images of organs or tissues of interest, a process called scintigraphy [ [5] , [6] , [7] ], allowing to investigate any abnormalities, which turns the technique in a non-invasive procedure. Furthermore, as the substance containing the radiopharmaceutical is designed to target specific organs, tissues, or cells, the technique increases the effectiveness of treatment while minimizing damage to healthy tissue [ [8] , [9] , [10] ].…”

Section: Introductionmentioning

confidence: 99%

Data reconciliation connected to guard bands to set specification limits related to risk assessment for radiopharmaceutical activity

Pereira,

Carvalheira,

Lopes

et al. 2023

Heliyon

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Comparison between MIBI-based radiopharmaceuticals for parathyroid scintigraphy: quantitative evaluation and correlation with clinical-laboratory parameters

Cited by 2 publications

References 19 publications

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Pitfalls of DualTracer 99m-Technetium (Tc) Pertechnetate and Sestamibi Scintigraphy before Parathyroidectomy: Between Primary-Hyperparathyroidism-Associated Parathyroid Tumour and Ectopic Thyroid Tissue

Data reconciliation connected to guard bands to set specification limits related to risk assessment for radiopharmaceutical activity

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