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Parathyroid Imaging

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99mTc-Sestamibi

Abstract

The majority of humans have four parathyroid glands, which are located at the upper and lower pole of the thyroid gland. Approximately 3–6% have less than four glands, whereas approximately 5–13% have more than four parathyroids. The parathyroid glands are derived from the third (inferior parathyroid) and fourth (superior parathyroid) branchial pouches. The inferior parathyroid glands migrate caudally with the thymus and are more variable in their location. Ectopic glands are found between the carotid bifurcation and the anterior mediastinum and occur in 15–20% of cases. Parathyroid tissue may be located within the thyroid gland in about 8% of cases.

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References

  1. Ruf J, Lopez Hanninen E et al (2004) Preoperative localization of parathyroid glands. Use of MRI, scintigraphy, and image fusion. Nuklearmedizin 43(3):85–90

    PubMed  CAS  Google Scholar 

  2. Weber AL, Randolph G et al (2000) The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am 38(5):1105–1129

    PubMed  CAS  Google Scholar 

  3. Greenspan B, Brown ML, et al (2004) The society of nuclear medicine procedure guideline for parathyroid scintigraphy, version 3.0

    Google Scholar 

  4. Ferlin G, Borsato N et al (1983) New perspectives in localizing enlarged parathyroids by technetium-thallium subtraction scan. J Nucl Med 24(5):438–441

    PubMed  CAS  Google Scholar 

  5. Taillefer R, Boucher Y et al (1992) Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study). J Nucl Med 33(10):1801–1807

    PubMed  CAS  Google Scholar 

  6. Coakley AJ, Kettle AG et al (1989) 99Tcm sestamibi – a new agent for parathyroid imaging. Nucl Med Commun 10(11):791–794

    PubMed  CAS  Google Scholar 

  7. O’Doherty MJ, Kettle AG et al (1992) Parathyroid imaging with technetium-99m-sestamibi: preoperative localization and tissue uptake studies. J Nucl Med 33(3):313–318

    PubMed  Google Scholar 

  8. Giordano A, Rubello D et al (2001) New trends in parathyroid scintigraphy. Eur J Nucl Med 28(9):1409–1420

    PubMed  CAS  Google Scholar 

  9. Greenspan BS, Brown ML et al (1998) Procedure guideline for parathyroid scintigraphy. Society of Nuclear Medicine. J Nucl Med 39(6):1111–1114

    PubMed  CAS  Google Scholar 

  10. Benard F, Lefebvre B et al (1995) Rapid washout of technetium-99m-MIBI from a large parathyroid adenoma. J Nucl Med 36(2):241–243

    PubMed  CAS  Google Scholar 

  11. Hindie E, Melliere D et al (1998) Parathyroid imaging using simultaneous double-window recording of technetium-99m-sestamibi and iodine-123. J Nucl Med 39(6):1100–1105

    PubMed  CAS  Google Scholar 

  12. Rubello D, Saladini G et al (2000) Parathyroid imaging with pertechnetate plus perchlorate/MIBI subtraction scintigraphy: a fast and effective technique. Clin Nucl Med 25(7):527–531

    PubMed  CAS  Google Scholar 

  13. Casara D, Rubello D et al (2001) Clinical role of 99mTcO4/MIBI scan, ultrasound and intra-operative gamma probe in the performance of unilateral and minimally invasive surgery in primary hyperparathyroidism. Eur J Nucl Med 28(9):1351–1359

    PubMed  CAS  Google Scholar 

  14. Torregrosa JV, Palomar MR et al (1998) Has double-phase MIBI scintigraphy usefulness in the diagnosis of hyperparathyroidism? Nephrol Dial Transplant 13(Suppl 3):37–40

    PubMed  Google Scholar 

  15. Fujii H, Kubo A (2000) Parathyroid imaging with technetium-99m sestamibi. Biomed Pharmacother 54(Suppl 1):12s–16s

    PubMed  Google Scholar 

  16. Billotey C, Sarfati E et al (1996) Advantages of SPECT in technetium-99m-sestamibi parathyroid scintigraphy. J Nucl Med 37(11):1773–1778

    PubMed  CAS  Google Scholar 

  17. Moka D, Voth E et al (2000) Technetium 99m-MIBI-SPECT: a highly sensitive diagnostic tool for localization of parathyroid adenomas. Surgery 128(1):29–35

    PubMed  CAS  Google Scholar 

  18. Lorberboym M, Minski I et al (2003) Incremental diagnostic value of preoperative 99mTc-MIBI SPECT in patients with a parathyroid adenoma. J Nucl Med 44(6):904–908

    PubMed  Google Scholar 

  19. Profanter C, Wetscher GJ et al (2004) CT-MIBI image fusion: a new preoperative localization technique for primary, recurrent, and persistent hyperparathyroidism. Surgery 135(2):157–162

    PubMed  Google Scholar 

  20. Fukumoto M (2004) Single-photon agents for tumor imaging: 201Tl, 99mTc-MIBI, and 99mTc-tetrofosmin. Ann Nucl Med 18(2):79–95

    PubMed  CAS  Google Scholar 

  21. Schachter PP, Issa N et al (2004) Early, postinjection MIBI-SPECT as the only preoperative localizing study for minimally invasive parathyroidectomy. Arch Surg 139(4):433–437

    PubMed  Google Scholar 

  22. Krausz Y, Bettman L et al (2006) Technetium-99m-MIBI SPECT/CT in primary hyperparathyroidism. World J Surg 30(1):76–83

    PubMed  Google Scholar 

  23. Hindie E, de LV, et al (2002) Parathyroid gland radionuclide scanning—methods and indications. Joint Bone Spine 69(1):28–36

    Google Scholar 

  24. Bergson EJ, Sznyter LA et al (2004) Sestamibi scans and intraoperative parathyroid hormone measurement in the treatment of primary hyperparathyroidism. Arch Otolaryngol Head Neck Surg 130(1):87–91

    PubMed  Google Scholar 

  25. Mullan BP (2004) Nuclear medicine imaging of the parathyroid. Otolaryngol Clin North Am 37(4):909–939, xi–xii

    PubMed  Google Scholar 

  26. Palestro CJ, Tomas MB et al (2005) Radionuclide imaging of the parathyroid glands. Semin Nucl Med 35(4):266–276

    PubMed  Google Scholar 

  27. Stefaniak B, Cholewinski W et al (2003) Application of artificial neural network algorithm to detection of parathyroid adenoma. Nucl Med Rev Cent East Eur 6(2):111–117

    PubMed  Google Scholar 

  28. Blocklet D, Martin P et al (1997) Presurgical localization of abnormal parathyroid glands using a single injection of technetium-99m methoxyisobutylisonitrile: comparison of different techniques including factor analysis of dynamic structures. Eur J Nucl Med 24(1):46–51

    PubMed  CAS  Google Scholar 

  29. Shon IH, Roach PJ et al (2001) Superimposed double parathyroid adenoma on Tc-99m MIBI imaging: the value of oblique images. Clin Nucl Med 26(10):876–877, x

    PubMed  CAS  Google Scholar 

  30. Custodio MR, Montenegro F et al (2005) MIBI scintigraphy, indicators of cell proliferation and histology of parathyroid glands in uraemic patients. Nephrol Dial Transplant 20(9):1898–1903

    PubMed  Google Scholar 

  31. Cermik TF, Puyan FO et al (2005) Relation between Tc-99m sestamibi uptake and biological factors in hyperparathyroidism. Ann Nucl Med 19(5):387–392

    PubMed  Google Scholar 

  32. Pons F, Torregrosa JV et al (2003) Biological factors influencing parathyroid localization. Nucl Med Commun 24(2):121–124

    PubMed  CAS  Google Scholar 

  33. Parikshak M, Castillo ED et al (2003) Impact of hypercalcemia and parathyroid hormone level on the sensitivity of preoperative sestamibi scanning for primary hyperparathyroidism. Am Surg 69(5):393–398; discussion 399

    PubMed  Google Scholar 

  34. Hung GU, Wang SJ et al (2003) Tc-99m MIBI parathyroid scintigraphy and intact parathyroid hormone levels in hyperparathyroidism. Clin Nucl Med 28(3):180–185

    PubMed  Google Scholar 

  35. Siegel A, Alvarado M et al (2006) Parameters in the prediction of the sensitivity of parathyroid scanning. Clin Nucl Med 31(11):679–682

    PubMed  Google Scholar 

  36. Karam M, Dansereau RN et al (2005) Increasing the radiochemical purity of 99mTc sestamibi commercial preparations results in improved sensitivity of dual-phase planar parathyroid scintigraphy. Nucl Med Commun 26(12):1093–1098

    PubMed  CAS  Google Scholar 

  37. Gupta VK, Yeh KA et al (1998) 99m-Technetium sestamibi localized solitary parathyroid adenoma as an indication for limited unilateral surgical exploration. Am J Surg 176(5):409–412

    PubMed  CAS  Google Scholar 

  38. Takebayashi S, Hidai H et al (1999) Hyperfunctional parathyroid glands with 99mTc-MIBI scan: semiquantitative analysis correlated with histologic findings. J Nucl Med 40(11):1792–1797

    PubMed  CAS  Google Scholar 

  39. Krausz Y, Lebensart PD et al (2000) Preoperative localization of parathyroid adenoma in patients with concomitant thyroid nodular disease. World J Surg 24(12):1573–1578

    PubMed  CAS  Google Scholar 

  40. Krausz Y, Shiloni E et al (2001) Diagnostic dilemmas in parathyroid scintigraphy. Clin Nucl Med 26(12):997–1001

    PubMed  CAS  Google Scholar 

  41. Masatsugu T, Yamashita H et al (2005) Significant clinical differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease. Surg Today 35(5):351–356

    PubMed  Google Scholar 

  42. Lorberboym M, Ezri T et al (2005) Preoperative technetium Tc 99m sestamibi SPECT imaging in the management of primary hyperparathyroidism in patients with concomitant multinodular goiter. Arch Surg 140(7):656–660

    PubMed  Google Scholar 

  43. Lee VS, Spritzer CE (1998) MR imaging of abnormal parathyroid glands. AJR Am J Roentgenol 170(4):1097–1103

    PubMed  CAS  Google Scholar 

  44. Friedman K, Somervell H et al (2004) Effect of calcium channel blockers on the sensitivity of preoperative 99mTc-MIBI SPECT for hyperparathyroidism. Surgery 136(6):1199–1204

    PubMed  Google Scholar 

  45. Kiratli PO, Ceylan E et al (2004) Impaired Tc-99m MIBI uptake in the thyroid and parathyroid glands during early phase imaging in hemodialysis patients. Rev Esp Med Nucl 23(5):347–351

    PubMed  Google Scholar 

  46. Khan MS, Khan S et al (2006) Ectopic parathyroid adenoma with Tc-99m MIBI washout: role of SPECT. Clin Nucl Med 31(11):713–715

    PubMed  Google Scholar 

  47. Smith JR, Oates ME (2004) Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls. Radiographics 24(4):1101–1115

    PubMed  Google Scholar 

  48. Bonjer HJ, Bruining HA et al (1997) Intraoperative nuclear guidance in benign hyperparathyroidism and parathyroid cancer. Eur J Nucl Med 24(3):246–251

    PubMed  CAS  Google Scholar 

  49. Dackiw AP, Sussman JJ et al (2000) Relative contributions of technetium Tc 99m sestamibi scintigraphy, intraoperative gamma probe detection, and the rapid parathyroid hormone assay to the surgical management of hyperparathyroidism. Arch Surg 135(5):550–555; discussion 555–557

    PubMed  CAS  Google Scholar 

  50. Casara D, Rubello D et al (2002) 99mTc-MIBI radio-guided minimally invasive parathyroidectomy: experience with patients with normal thyroids and nodular goiters. Thyroid 12(1):53–61

    PubMed  Google Scholar 

  51. Rubello D, Fig LM et al (2006) Radioguided surgery of parathyroid adenomas and recurrent thyroid cancer using the “low sestamibi dose” protocol. Cancer Biother Radiopharm 21(3):194–205

    PubMed  Google Scholar 

  52. Goldstein RE, Billheimer D et al (2003) Sestamibi scanning and minimally invasive radioguided parathyroidectomy without intraoperative parathyroid hormone measurement. Ann Surg 237(5):722–730; discussion 730–721

    PubMed  Google Scholar 

  53. Bekis R, Aydin A et al (2004) The role of gamma probe activity counts in minimally invasive parathyroidectomy. Preliminary results. Nuklearmedizin 43(6):190–194

    PubMed  CAS  Google Scholar 

  54. Bozkurt MF, Ugur O et al (2003) Optimization of the gamma probe-guided parathyroidectomy. Am Surg 69(8):720–725

    PubMed  Google Scholar 

  55. Farley DR (2004) Technetium-99m 2-methoxyisobutyl isonitrile-scintigraphy: preoperative and intraoperative guidance for primary hyperparathyroidism. World J Surg 28(12):1207–1211

    PubMed  Google Scholar 

  56. Rubello D, Casara D et al (2003) Importance of radio-guided minimally invasive parathyroidectomy using hand-held gamma probe and low (99m)Tc-MIBI dose. Technical considerations and long-term clinical results. Q J Nucl Med 47(2):129–138

    PubMed  CAS  Google Scholar 

  57. Rubello D, Casara D et al (2003) Optimization of peroperative procedures. Nucl Med Commun 24(2):133–140

    PubMed  CAS  Google Scholar 

  58. Rubello D, Mariani G et al (2006) Minimally invasive radio-guided parathyroidectomy: long-term results with the ‘low 99mTc-sestamibi protocol’. Nucl Med Commun 27(9):709–713

    PubMed  Google Scholar 

  59. Rubello D, Pelizzo MR et al (2005) Radioguided surgery of primary hyperparathyroidism using the low-dose 99mTc-sestamibi protocol: multiinstitutional experience from the Italian Study Group on Radioguided Surgery and Immunoscintigraphy (GISCRIS). J Nucl Med 46(2):220–226

    PubMed  Google Scholar 

  60. Takeyama H, Shioya H et al (2004) Usefulness of radio-guided surgery using technetium-99m methoxyisobutylisonitrile for primary and secondary hyperparathyroidism. World J Surg 28(6):576–582

    PubMed  Google Scholar 

  61. Ugur O, Bozkurt MF et al (2004) Clinicopathologic and radiopharmacokinetic factors affecting gamma probe-guided parathyroidectomy. Arch Surg 139(11):1175–1179

    PubMed  Google Scholar 

  62. Ruda J, Stack BC Jr et al (2004) The cost-effectiveness of sestamibi scanning compared to bilateral neck exploration for the treatment of primary hyperparathyroidism. Otolaryngol Clin North Am 37(4):855–870, x–xi

    PubMed  Google Scholar 

  63. Mekel M, Mahajna A et al (2005) Minimally invasive surgery for treatment of hyperparathyroidism. Isr Med Assoc J 7(5):323–327

    PubMed  Google Scholar 

  64. Marx UC, Adermann K et al (2000) Solution structures of human parathyroid hormone fragments hPTH(1–34) and hPTH(1–39) and bovine parathyroid hormone fragment bPTH(1–37). Biochem Biophys Res Commun 267(1):213–220

    PubMed  CAS  Google Scholar 

  65. Perrier ND, Ituarte PH et al (2002) Parathyroid surgery: separating promise from reality. J Clin Endocrinol Metab 87(3):1024–1029

    PubMed  CAS  Google Scholar 

  66. Udelsman R (2002) Surgery in primary hyperparathyroidism: the patient without previous neck surgery. J Bone Miner Res 17(Suppl 2):N126–N132

    PubMed  Google Scholar 

  67. Shaha AR (2004) Parathyroid re-exploration. Otolaryngol Clin North Am 37(4):833–843, x

    PubMed  Google Scholar 

  68. Johnson NA, Tublin ME et al (2007) Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. AJR Am J Roentgenol 188(6):1706–1715

    PubMed  Google Scholar 

  69. Stephen AE, Chen KT et al (2004) The coming of age of radiation-induced hyperparathyroidism: evolving patterns of thyroid and parathyroid disease after head and neck irradiation. Surgery 136(6):1143–1153

    PubMed  Google Scholar 

  70. Massaro A, Cittadin S et al (2007) Accurate planning of minimally invasive surgery of parathyroid adenomas by means of [(99m)Tc]MIBI SPECT. Minerva Endocrinol 32(1):9–16

    PubMed  CAS  Google Scholar 

  71. Ortega A, Perez de Prada MT et al (2007) Effect of parathyroid-hormone-related protein on human platelet activation. Clin Sci Lond 113(7):319–327

    PubMed  CAS  Google Scholar 

  72. Mariani G, Gulec SA et al (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44(9):1443–1458

    PubMed  Google Scholar 

  73. Rubello D, Mariani G (2007) Hand-held gamma probe or hand-held miniature gamma camera for minimally invasive parathyroidectomy: Competition, evolution or synergy? Eur J Nucl Med Mol Imaging 34(2):162–164

    PubMed  Google Scholar 

  74. Murphy C, Norman J (1999) The 20% rule: a simple, instantaneous radioactivity measurement defines cure and allows elimination of frozen sections and hormone assays during parathyroidectomy. Surgery 126(6):1023–1028, discussion 1028–1029

    PubMed  CAS  Google Scholar 

  75. Friedman M, Gurpinar B et al (2007) Guidelines for radioguided parathyroid surgery. Arch Otolaryngol Head Neck Surg 133(12):1235–1239

    PubMed  Google Scholar 

  76. Lo CY, Lang BH et al (2007) A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism. Am J Surg 193(2):155–159

    PubMed  CAS  Google Scholar 

  77. Nichols KJ, Tomas MB et al (2008) Preoperative parathyroid scintigraphic lesion localization: accuracy of various types of readings. Radiology 248(1):221–232

    PubMed  Google Scholar 

  78. Civelek AC, Ozalp E et al (2002) Prospective evaluation of delayed technetium-99m sestamibi SPECT scintigraphy for preoperative localization of primary hyperparathyroidism. Surgery 131(2):149–157

    PubMed  Google Scholar 

  79. Miccoli P, Ambrosini CE et al (2007) New technologies in thyroid surgery. Endoscopic thyroid surgery. Minerva Chir 62(5):335–349

    PubMed  CAS  Google Scholar 

  80. Kukora JS, Zeiger M (2005) The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract 11(1):49–54

    Google Scholar 

  81. Bilezikian JP, Potts JT Jr et al (2002) Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Clin Endocrinol Metab 87(12):5353–5361

    PubMed  CAS  Google Scholar 

  82. Sackett WR, Barraclough B et al (2002) Worldwide trends in the surgical treatment of primary hyperparathyroidism in the era of minimally invasive parathyroidectomy. Arch Surg 137(9):1055–1059

    PubMed  Google Scholar 

  83. McHenry CR (2002) What’s new in general surgery: endocrine surgery. J Am Coll Surg 195(3):364–371

    PubMed  Google Scholar 

  84. Pasieka JL (2004) What’s new in general surgery: endocrine surgery. J Am Coll Surg 199(3):437–445

    PubMed  Google Scholar 

  85. Lomonte C, Buonvino N et al (2006) Sestamibi scintigraphy, topography, and histopathology of parathyroid glands in secondary hyperparathyroidism. Am J Kidney Dis 48(4):638–644

    PubMed  Google Scholar 

  86. Nishida H, Ishibashi M et al (2005) Comparison of histological findings and parathyroid scintigraphy in hemodialysis patients with secondary hyperparathyroid glands. Endocr J 52(2):223–228

    PubMed  Google Scholar 

  87. Owda AK, Mousa D et al (2002) Long-term intravenous calcitriol in secondary hyperparathyroidism: the role of technetium-99m-MIBI scintigraphy in predicting the response to treatment. Ren Fail 24(2):165–173

    PubMed  CAS  Google Scholar 

  88. Wells SA Jr, Debenedetti MK et al (2002) Recurrent or persistent hyperparathyroidism. J Bone Miner Res 17(Suppl 2):N158–N162

    PubMed  Google Scholar 

  89. Gotway MB, Reddy GP et al (2001) Comparison between MR imaging and 99mTc MIBI scintigraphy in the evaluation of recurrent of persistent hyperparathyroidism. Radiology 218(3):783–790

    PubMed  CAS  Google Scholar 

  90. Martin D, Rosen IB et al (1996) Evaluation of single isotope technetium 99M-sestamibi in localization efficiency for hyperparathyroidism. Am J Surg 172(6):633–636

    PubMed  CAS  Google Scholar 

  91. Castellani M, Reschini E et al (2001) Role of Tc-99m sestamibi scintigraphy in the diagnosis and surgical decision-making process in primary hyperparathyroid disease. Clin Nucl Med 26(2):139–144

    PubMed  CAS  Google Scholar 

  92. Sprouse LR 2nd, Roe SM et al (2001) Minimally invasive parathyroidectomy without intraoperative localization. Am Surg 67(11):1022–1029

    PubMed  Google Scholar 

  93. Zettinig G, Prager G et al (2002) Value of a structured report for the interpretation of parathyroid scintigraphy in primary essential hyperthyroidism. Acta Med Austriaca 29(2):68–71

    PubMed  CAS  Google Scholar 

  94. Panzironi G, Falvo L et al (2002) Preoperative evaluation of primary hyperparathyroidism: role of diagnostic imaging. Chir Ital 54(5):629–634

    PubMed  Google Scholar 

  95. Clark PB, Case D et al (2003) Enhanced scintigraphic protocol required for optimal preoperative localization before targeted minimally invasive parathyroidectomy. Clin Nucl Med 28(12):955–960

    PubMed  Google Scholar 

  96. Prager G, Czerny C et al (2003) Impact of localization studies on feasibility of minimally invasive parathyroidectomy in an endemic goiter region. J Am Coll Surg 196(4):541–548

    PubMed  Google Scholar 

  97. Khaliq T, Khawar A et al (2003) Unilateral exploration for primary hyperparathyroidism. J Coll Physicians Surg Pak 13(10):588–591

    PubMed  Google Scholar 

  98. Gotthardt M, Lohmann B et al (2004) Clinical value of parathyroid scintigraphy with technetium-99m methoxyisobutylisonitrile: discrepancies in clinical data and a systematic metaanalysis of the literature. World J Surg 28(1):100–107

    PubMed  Google Scholar 

  99. Mortier PE, Mozzon MM et al (2004) Unilateral surgery for hyperparathyroidism: indications, limits, and late results—New philosophy or expensive selection without improvement of surgical results? World J Surg 28(12):1298–1304

    PubMed  Google Scholar 

  100. Ruda JM, Hollenbeak CS et al (2005) A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg 132(3):359–372

    PubMed  Google Scholar 

  101. Carneiro-Pla DM, Solorzano CC et al (2006) Consequences of targeted parathyroidectomy guided by localization studies without intraoperative parathyroid hormone monitoring. J Am Coll Surg 202(5):715–722

    PubMed  Google Scholar 

  102. Kairys JC, Daskalakis C et al (2006) Surgeon-performed ultrasound for preoperative localization of abnormal parathyroid glands in patients with primary hyperparathyroidism. World J Surg 30(9):1658–1663; discussion 1664

    PubMed  Google Scholar 

  103. Gawande AA, Monchik JM et al (2006) Reassessment of parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism after 2 preoperative localization studies. Arch Surg 141(4):381–384; discussion 384

    PubMed  CAS  Google Scholar 

  104. Fuster D, Ybarra J et al (2006) Role of pre-operative imaging using 99mTc-MIBI and neck ultrasound in patients with secondary hyperparathyroidism who are candidates for subtotal parathyroidectomy. Eur J Nucl Med Mol Imaging 33(4):467–473

    PubMed  Google Scholar 

  105. Solorzano CC, Carneiro-Pla D et al (2005) Surgical management of primary hyperparathyroidism: the case for giving up quick intraoperative PTH assay in favor of routine measurement the morning after. Ann Surg 242(6):904, author reply 904–905

    PubMed  Google Scholar 

  106. Seehofer D, Steinmuller T et al (2004) Parathyroid hormone venous sampling before reoperative surgery in renal hyperparathyroidism: comparison with noninvasive localization procedures and review of the literature. Arch Surg 139(12):1331–1338

    PubMed  Google Scholar 

  107. Clark P, Wooldridge T et al (2004) Providing optimal preoperative localization for recurrent parathyroid carcinoma: a combined parathyroid scintigraphy and computed tomography approach. Clin Nucl Med 29(11):681–684

    PubMed  Google Scholar 

  108. Saint Marc O, Cogliandolo A et al (2004) Prospective evaluation of ultrasonography plus MIBI scintigraphy in selecting patients with primary hyperparathyroidism for unilateral neck exploration under local anaesthesia. Am J Surg 187(3):388–393

    PubMed  Google Scholar 

  109. Gross ND, Wax MK (2004) Unilateral and bilateral surgery for parathyroid disease. Otolaryngol Clin North Am 37(4):799–817, ix–x

    PubMed  Google Scholar 

  110. Kebapci M, Entok E et al (2004) Preoperative evaluation of parathyroid lesions in patients with concomitant thyroid disease: role of high resolution ultrasonography and dual phase technetium 99 m sestamibi scintigraphy. J Endocrinol Invest 27(1):24–30

    PubMed  CAS  Google Scholar 

  111. Miura D, Wada N et al (2002) Does intraoperative quick parathyroid hormone assay improve the results of parathyroidectomy? World J Surg 26(8):926–930

    PubMed  Google Scholar 

  112. Wakamatsu H, Noguchi S et al (2001) Technetium-99m tetrofosmin for parathyroid scintigraphy: a direct comparison with (99m)Tc-MIBI, (201)Tl, MRI and US. Eur J Nucl Med 28(12):1817–1827

    PubMed  CAS  Google Scholar 

  113. De Feo ML, Colagrande S et al (2000) Parathyroid glands: combination of (99m)Tc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology 214(2):393–402

    PubMed  Google Scholar 

  114. Wada A, Sugihara M et al (1999) Magnetic resonance imaging (MRI) and technetium-99m-methoxyisonitrile (MIBI) scintigraphy to evaluate the abnormal parathyroid gland and PEIT efficacy for secondary hyperparathyroidism. Radiat Med 17(4):275–282

    PubMed  CAS  Google Scholar 

  115. Pattou F, Oudar C et al (1998) Localization of abnormal parathyroid glands with jugular sampling for parathyroid hormone, and subtraction scanning with sestamibi or tetrofosmine. Aust N Z J Surg 68(2):108–111

    PubMed  CAS  Google Scholar 

  116. Ishibashi M, Nishida H et al (1998) Comparison of technetium-99m-MIBI, technetium-99m-tetrofosmin, ultrasound and MRI for localization of abnormal parathyroid glands. J Nucl Med 39(2):320–324

    PubMed  CAS  Google Scholar 

  117. Peeler BB, Martin WH et al (1997) Sestamibi parathyroid scanning and preoperative localization studies for patients with recurrent/persistent hyperparathyroidism or significant comorbid conditions: development of an optimal localization strategy. Am Surg 63(1):37–46

    PubMed  CAS  Google Scholar 

  118. Mazzeo S, Caramella D et al (1996) Comparison among sonography, double-tracer subtraction scintigraphy, and double-phase scintigraphy in the detection of parathyroid lesions. AJR Am J Roentgenol 166(6):1465–1470

    PubMed  CAS  Google Scholar 

  119. Lee VS, Spritzer CE et al (1996) The complementary roles of fast spin-echo MR imaging and double-phase 99m Tc-sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands. AJR Am J Roentgenol 167(6):1555–1562

    PubMed  CAS  Google Scholar 

  120. International Commission on Radiological Protection (1988) Radiation dose to patients from radiopharmaceuticals. IRRP publication 53. ICRP, London p 199,264,373

    Google Scholar 

  121. International Commission on Radiological Protection (1993) Radiation protection in biomedical research. ICRP publication 62. Pergamon Press, New York, p 23

    Google Scholar 

  122. Uruno T, Kebebew E (2006) How to localize parathyroid tumors in primary hyperparathyroidism? J Endocrinol Invest 29(9):840–847

    PubMed  CAS  Google Scholar 

  123. Funari M, Campos Z et al (1992) MRI and ultrasound detection of asymptomatic thyroid nodules in hyperparathyroidism. J Comput Assist Tomogr 16(4):615–619

    PubMed  CAS  Google Scholar 

  124. Petti GH Jr, Chonkich GD et al (1993) Unilateral parathyroidectomy: the value of the localizing scan. J Otolaryngol 22(4):307–310

    PubMed  Google Scholar 

  125. Yousem DM (1996) Parathyroid and thyroid imaging. Neuroimaging Clin N Am 6(2):435–459

    PubMed  CAS  Google Scholar 

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Correspondence to Hans-Jürgen Biersack .

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Biersack, HJ., Heiden, U. (2012). Parathyroid Imaging. In: Bucerius, J., Ahmadzadehfar, H., Biersack, HJ. (eds) 99mTc-Sestamibi. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-04233-1_4

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