ENDOCRINOLOGY - I
Diagnostic procedures 

The Quarterly Journal of Nuclear Medicine 1999 September;43(3):207-16

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Parathyroid scintigraphy

Geatti O.

From the Division of Nuclear Medicine Azienda “Ospedali Riuniti di Trieste”, Trieste, Italy

Para­thy­roid scin­tig­raphy, ­first pro­posed in the sev­en­ties, has devel­oped an irre­place­able ­role in the pre­op­er­a­tive loca­tion of ­enlarged para­thy­roid tis­sues. The con­tri­bu­tion of ­Ferlin, who in the ­early ­eighties pro­posed the use of the potas­sium ana­logue 201Thal­lium and sub­trac­tion scin­tig­raphy to ­obviate thy­roid ­tissue inter­fer­ence was espe­cially impor­tant.
At the ­present ­time, ­this ­imaging ­modality, is ­widely ­accepted for the pre­op­er­a­tive local­iza­tion of para­thy­roid aden­omas ­owing to its ­high accu­racy and repro­du­cibility. Var­ious mod­i­fied acqui­si­tion and pro­cessing pro­to­cols ­have ­been ­reported and 201Thal­lium ­still con­tinues to be ­used, but ­other radio­phar­ma­ceu­ti­cals, ­such as 99mTc-methox­yi­sob­utyl iso­ni­trile (99mTc-­MIBI) and 99mTc-tet­ro­fosmin are now ­often pre­ferred, espe­cially ­because of the ­more favour­able phys­ical prop­er­ties of the Tech­ne­tium label­ling.
In ­some ­cases, thy­roid sub­trac­tion scin­tig­raphy can be ­replaced by ­dual ­phase 99mTc-methox­yi­sob­utyl iso­ni­trile acqui­si­tion. ­There is ­also an ­increasing ­interest in ­SPECT ­studies, ­which ­have the poten­tial to ­more accu­rately ­locate the ­sites of aden­omas and ­allow for detec­tion of ­smaller ­lesions, ­which fur­ther ­increases ­total sen­si­tivity and accu­racy of the tech­nique.