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Usefulness of 99mTc-SESTAMIBI Scintigraphy in Persistent Hyperparathyroidism after Kidney Transplant
- Source :
- Nucl Med Mol Imaging
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- PURPOSE: (99m)Tc-labeled sestamibi scintigraphy combined with single-photon emission computed tomography (SPECT) has a high positive predictive value for localizing hyperfunctioning parathyroid lesions in primary hyperparathyroidism (pHPT) but relatively low sensitivity and specificity in secondary hyperparathyroidism (sHPT) and tertiary hyperparathyroidism (tHPT). The purpose of this study is to investigate the usefulness of (99m)Tc-sestamibi scintigraphy in persistent hyperparathyroidism after kidney transplant (KT). METHODS: Retrospectively evaluated 50 patients who received parathyroidectomy after KT at a single medical center. The parathyroid lesion with the highest sestamibi uptake intensity of a patient was graded from 0 to 3. Uptake intensity was analyzed in correlation with parathyroid hormone (PTH), calcium, ionized calcium, phosphorus, and vitamin D. RESULTS: Per-patient analysis, 43 patients had hyperplasia, 6 patients had adenomas, and 1 patient had a carcinoma. Only 3 patients with hyperplasia did not demonstrate any sestamibi uptake in the parathyroid scans. Out of the 148 pathologically confirmed parathyroid lesions, SPECT/CT images were able to identify 89 lesions (60%) and planar images of 71 lesions (48%). The average of sestamibi uptake intensity was mild at grade 1.6. Uptake intensity showed a positive correlation with parathyroid hormone (PTH) level but not with phosphorus, calcium, ionized calcium, or vitamin D levels. The largest lesion showed a high positive predictive value, especially in lesions with a diameter over 1.0 cm. CONCLUSIONS: Regardless of relatively low and less discrete uptake in KT patients, it well depicts the largest and the most hyperfunctioning lesion.
- Subjects :
- Parathyroidectomy
Calcium metabolism
medicine.diagnostic_test
business.industry
medicine.medical_treatment
Parathyroid hormone
medicine.disease
Scintigraphy
Tertiary hyperparathyroidism
Lesion
medicine
Original Article
Radiology, Nuclear Medicine and imaging
Secondary hyperparathyroidism
medicine.symptom
business
Nuclear medicine
Primary hyperparathyroidism
Subjects
Details
- ISSN :
- 18693482 and 18693474
- Volume :
- 55
- Database :
- OpenAIRE
- Journal :
- Nuclear Medicine and Molecular Imaging
- Accession number :
- edsair.doi.dedup.....e427427cb0f5600e12942b2c749211dc