The Sestamibi Scan as a Preoperative Screening Tool

Norton, Kathryn S.; Johnson, Lester W.; Griffen, F. Dean; Burke, James; Kennedy, Suzanne; Aultman, Donnie; Li, Benjamin D.L.; Zibari, Gazi
September 2002
American Surgeon;Sep2002, Vol. 68 Issue 9, p812
Academic Journal
Sestamibi scan is generally recognized in the literature to play a role in the imaging of parathyroid adenoma. Most institutions quote sensitivities ranging from 80 to 100 per cent. There is still a question as to whether patients need preoperative localization studies. Preoperative localization can potentially result in less invasive surgery, shorter operative times, decreased hospital stays, and decreased need for re-exploration. Our hypothesis is that the sestamibi scan is a sensitive predictor of parathyroid adenomas. The objectives of this study are to determine the sensitivity of sestamibi scan in detecting parathyroid adenoma, and to determine whether either parathyroid hormone (PTH) level or calcium level is an independent predictor of a positive scan. One hundred patients were retrospectively reviewed at Louisiana State University Health Sciences Center-Shreveport and Louisiana State University Health Sciences Center-Monroe from March 1993 through December 2000. All patients had a preoperative sestamibi scan. This scan was performed using the dual-phase technique in which the parathyroid glands are visualized after washout of tracer from the thyroid. The scan was followed by either a unilateral or bilateral neck dissection. There were 82 female patients and 18 male patients who ranged in age from 23 to 78 years. The median weight of glands with a positive scan was 795 mg. The median weight of glands with a negative scan was 480 mg. This difference was statistically significant (P < 0.04). Overall there were 107 adenomas. Of these 93 had positive scans and 14 had negative scans. This results in a sensitivity of 87 per cent. There were 67 glands that weighed at least 500 mg. Of these 67 glands 61 had positive scans and six had negative scans. This resulted in a sensitivity of 91 per cent. There were 40 glands that weighed less than 500 mg. Of these 40 glands 32 had positive scans and eight had negative scans. This resulted in a sensitivity of 80 per...


Related Articles

  • Cystic Parathyroid Adenoma: An Unusual Cause of Hypercalcemic Crisis. Şahin, Serap Baydur; Şahin, Osman Zikrullah; Sümer, Fatih; Oğullar, Sabri; Ayaz, Teslime; Bedir, Recep; Yücel, Ahmet Fikret // Turkish Journal of Endocrinology & Metabolism;6/1/2014, Vol. 18 Issue 2, p64 

    Parathyroid crisis is a rare clinical entity characterized by life-threatening hypercalcemia of a sudden onset in patients with primary hyperparathyroidism (pHTP) and rarely results from a cystic adenoma. We describe a 53-year-old woman with acute hypercalcemic crisis who presented with severe...

  • Adenoma de Paratiroides en gammagrafía. Carranza, Julio; Miyahira, Juan // Revista Medica Herediana;abr-jun2012, Vol. 23 Issue 2, p143 

    No abstract available.

  • Malignancy of parathyroid: An uncommon clinical entity. Ali, Kamran; Sarangi, Rathindra; Dhawan, Shashi; Agarwal, Brij B.; Gupta, Manish K. // Indian Journal of Endocrinology & Metabolism;Mar/Apr2013, Vol. 17 Issue 2, p329 

    Parathyroid carcinoma is a very rare cause of hyperparathyroidism. The diagnosis is usually established on histopathological grounds of capsular and vascular invasion, but a potential clue to the diagnosis is also offered by the severity of clinical profile, abrupt onset of symptoms, and a high...

  • Intra-operative parathyroid hormone assay for simplified localization of parathyroid adenomas. Saharay, M.; Farooqui, A.; Farrow, S.; Fahie-Wilson, M.; Brown, A. // Journal of the Royal Society of Medicine;May1996, Vol. 89 Issue 5, p261 

    Lack of success in parathyroid surgery is usually due to failure to identify the abnormal parathyroid gland correctly at operation. The surgeon may be helped by rapid parathyroid hormone (PTH) assay in peripheral blood after removal of a suspected adenoma, and by frozen section histology, but...

  • Weight Difference Between Double Parathyroid Adenomas Is the Cause of False-positive IOPTH Test After Resection of the First Lesion. Sitges-Serra, Antonio; Javier Díaz-Aguirregoitia, Francisco; de la Quintana, Aitor; Gil-Sánchez, Jesús; Jimeno, Jaime; Prieto, Rosa; Sancho, Joan J. // World Journal of Surgery;Jun2010, Vol. 34 Issue 6, p1337 

    Some patients with double parathyroid adenoma show a greater than 50% decline in intraoperative parathyroid hormone (IOPTH) after resection of the first lesion. The present study was designed to test the hypothesis that significant adenoma weight differences may explain this inappropriate...

  • A Parathyroid Adenoma: Benign Disease Presenting with Hyperparathyroid Crisis. Tahim, A. S.; Saunders, J.; Sinha, P. // Case Reports in Medicine;2010, p1 

    Hyperparathyroid crisis is a raremanifestation of parathyroid disease.We present the case of a 53-year-old gentleman with a review of the current literature. He presented in acute renal failure with epigastric pain and vomiting. His serum-corrected calcium (CCa2+) was raised at 5.2 mmol/L, in...

  • parathyroid tumour. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p589 

    An encyclopedia entry for "parathyroid tumor" is presented. It refers to a growth within a parathyroid gland. Hyperparathyroidism occurs when the tumor causes excess secretion of parathyroid hormone (PTH). Most parathyroid tumors are noncancerous adenomas and parathyroid cancers are very rare.

  • Non-functional parathyroid cyst - diagnostic pitfall: A case-report. Polovina, Snežana P.; Andjelković, Zoran; Micić, Dragan D. // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Nov2015, Vol. 72 Issue 11, p1032 

    Introduction. Parathyroid cysts are relative rare and they may be misdiagnosed with thyroid nodules. Parathyroid cysts are characterized by elevated level of parathyroid hormone (PTH) in cystic fluid. Case report. We reported about middle-aged woman with palpable node in the left thyroid lobe....

  • Gallium nitrate for treatment of refractory hypercalcemia from parathyroid carcinoma. Warrell Jr., Raymond P.; Issacs, Marian; Alcock, Nancy W.; Bockman, Richard S.; Warrell, R P Jr; Issacs, M; Alcock, N W; Bockman, R S // Annals of Internal Medicine;Nov87, Vol. 107 Issue 5, p683 

    Intractable hypercalcemia is the major cause of morbidity and mortality in patients with parathyroid carcinoma. Because gallium nitrate previously was shown to inhibit the bone resorptive activity of parathyroid hormone (PTH) in vitro, we used it to treat two patients with parathyroid carcinoma...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics