Parathyroid Adenomas and Hyperplasia: Dual Radionuclide Scintigraphy and Bone Densitometry Studies

• Published in: Clinical nuclear medicine 1985-04, Vol.10 (4), p.243-247
• Main Authors: GUPTA, SHIV M, BELSKY, JOSEPH L, SPENCER, RICHARD P, FRIAS, JUAN, KOTCH, PHILIP, HALPIN, THOMAS, HERRERA, NILO E
• Format: Article
• Language: English
• Subjects: Adenoma - complications; Adenoma - diagnostic imaging; Adult; Aged; Biological and medical sciences; Bone and Bones - diagnostic imaging; Densitometry; Endocrine glands. Genital system. Mammary gland; Female; Humans; Hyperparathyroidism - diagnostic imaging; Hyperparathyroidism - etiology; Hyperparathyroidism, Secondary - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Minerals - analysis; Parathyroid Hormone - blood; Parathyroid Neoplasms - complications; Parathyroid Neoplasms - diagnostic imaging; Radioisotopes; Radionuclide Imaging; Radionuclide investigations; Radius - diagnostic imaging; Sodium Pertechnetate Tc 99m; Space life sciences; Subtraction Technique; Thallium
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/00003072-198504000-00003

Dual radionuclide imaging of the neck (Tc-99m pertechnetate and TI-201 thallous chloride) was performed in 22 patients with chemical evidence of hyperparathyroidism (elevated blood calcium and parathormone [PTH] levels). Of these, 19 of 22 had localization of a TI-201 “excess” area on radiothallium-radiotechnetium subtraction images. In 13 patients who have had operative confirmation at this writing, the dual radionuclide imaging was positive in 12 (12/13 = 92.3%). One patient had two parathyroid adenomas, both of which were seen on the images; thus, overall detection was 13 out of 14 or 92.8%. The parathyroid adenomas visualized weighed from 0.06 to 3.0 g; the one not detected weighed 0.25 g. In three patients with parathyroid hyperplasia secondary to renal disease, the subtraction imaging detected eight of 12 glands (66.7%). The forearm bone mineral content and bone density were determined in eight patients with parathyroid adenomas; results were abnormally low in five of these eight. One of the three patients with secondary hyperparathyroidism had an abnormally low radial bone mass. The combination of dual radionuclide imaging and radial bone mass determination may present a useful approach in both localizing abnormal parathyroid tissue and in examining its functional consequences.