Parathyroid Imaging after Intraarterial Injections of [⁷⁵Se]Selenomethionine*

Abstract

Thirteen patients with persistent hyperparathyroidism after unsuccessful neck surgery were given up to 250 microCi [75Se]selenomethionine intraarterially during parathyroid arteriography, gamma-Camera images of the neck and mediastinum localized abnormal parathyroids in four of five patients receiving complete injections, despite very small glands or unsuccessful arteriograms in some of the patients. Correctly localizing images were obtained in three patients receiving incomplete injections. However, images in five of eight of the remaining patients receiving incomplete injections showed areas of false positive uptake, and there was no way preoperatively to distinguish these from the true positive studies. We conclude that intraarterial injection of radioselenomethionine is a simple supplementary procedure in patients undergoing arteriography that may, with proper technique, be useful in identifying small foci of abnormal parathyroid tissue.

Prospective comparison of radionuclide, ultrasound, and computed tomography in the preoperative localization of parathyroid glands

“…The search for such a technique has continued for many years, commencing with palpation of the neck, barium swallow, and thermography. Selenomethionine scanning [1] is theoretically attractive, but it subjects the patient to a large radiation dosage and has not yet been made sufficiently accurate to be useful. Parathyroid venous sampling has accurately predicted the site of hyperplastic tissue in an impressive 87% of one large series [2], although other studies have not obtained such good results [3][4][5][6]--the usual rate being about 60%.…”

Surgical Neuroangiography

“…Parathyroid adenomas still represent a diagnostic challenge with the exception of very large tumors; the available non invasive techniques can rarely document the location of the hormone secreting lesion (Wolverson et al 1981, Obley et al 1984, Adams et al 1981, Stark 1983, Stock et al 1981,. Since contribution to the angiographic approach to parathyroid adenomas and Dunlop's (1980) review of venous sampling little attention has been devoted to angiographic studies in this disease.…”