Nuclear Medicine and Molecular Imaging

, Volume 45, Issue 4, pp 276–284 | Cite as

Differential Findings of Tc-99m Sestamibi Dual-Phase Parathyroid Scintigraphy Between Benign and Malignant Parathyroid Lesions in Patients with Primary Hyperparathyroidism

  • Miju Cheon
  • Joon Young ChoiEmail author
  • Jae-Hoon Chung
  • Ji Young Lee
  • Sook Kyung Cho
  • Jang Yoo
  • Soo Bin Park
  • Kyung-Han Lee
  • Byung-Tae Kim
Original Article



This study aimed to investigate the differential findings in clinical and biochemical features, and Tc-99m sestamibi (MIBI) dual-phase parathyroid scintigraphy for malignant and benign parathyroid lesions in patients with primary hyperparathyroidism.


Subjects were 102 parathyroid lesions from 91 patients with primary hyperparathyroidism. Scintigraphic findings included radioactivity grade, uptake pattern, uptake contour, lesion size on early and delayed images, and degree of washout. Clinical and biochemical features were also evaluated. Histopathology confirmed the final diagnosis for all the patients.


Final diagnoses were 94 benign parathyroid lesions and 8 parathyroid carcinomas. The patients with parathyroid carcinoma were significantly older (p = 0.002) and had significantly higher serum parathyroid hormone concentrations than those with benign parathyroid lesions (p < 0.001). All malignant parathyroid lesions showed intense radioactivity similar to or greater than the submandibular gland activity on delayed images (p = 0.007), and little radioactivity difference between early and delayed images (p = 0.012). The cancer incidence for parathyroid lesions with both intense radioactivity and no washout was 17.0% (8/47). When parathyroid lesions with all of the above-mentioned findings were regarded as malignant, the cancer incidence significantly increased from 17.0% to 33.3% (8/24, p < 0.001).


For Tc-99m MIBI dual-phase parathyroid scintigraphy, uptake grade on delayed images and washout were significantly useful diagnostic criteria for differentiating benign from malignant parathyroid lesions, along with age and parathyroid hormone serum concentration.


Primary hyperparathyroidism Parathyroid carcinoma Parathyroid adenoma Parathyroid hyperplasia Tc-99m Sestamibi Parathyroid scintigraphy 


Conflict of interest statement

All authors declare that they have no conflict of interest.


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Copyright information

© Korean Society of Nuclear Medicine 2011

Authors and Affiliations

  • Miju Cheon
    • 1
  • Joon Young Choi
    • 1
    Email author
  • Jae-Hoon Chung
    • 2
  • Ji Young Lee
    • 1
  • Sook Kyung Cho
    • 1
  • Jang Yoo
    • 1
  • Soo Bin Park
    • 1
  • Kyung-Han Lee
    • 1
  • Byung-Tae Kim
    • 1
  1. 1.Department of Nuclear Medicine, Samsung Medical Center, SungkyunkwanUniversity School of MedicineSeoulKorea
  2. 2.Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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