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A sestamibi parathyroid scan is a procedure in nuclear medicine which is performed to localize parathyroid adenoma, which causes Hyperparathyroidism. [1] Adequate localization of parathyroid adenoma allows the surgeon to use a minimally invasive surgical approach.
Nuclear medicine imaging methods are used by surgeons to locate which parathyroid gland is responsible for hyperparathyroidism or to find ectopic parathyroid adenomas, most commonly found in the anterior mediastinum. [citation needed] Historically, technetium sestamibi scintigraphy was the main method used or this indication. [39]
The parathyroid gland takes up 99m Tc MIBI following an intravenous injection, and the patient's neck is imaged with a gamma camera to show the location of all glands. A second image is obtained after a washout time (approximately 2 hours), and mitochondria in the oxyphil cells of the abnormal glands retaining the 99m Tc are seen with the gamma ...
Primary hyperparathyroidism is most commonly due to solitary parathyroid adenoma. Less commonly it may be due to double parathyroid adenomas or parathyroid hyperplasia. Tc99 sestamibi scan of head, neck and upper thorax is the most commonly used test for localizing parathyroid adenomas having a sensitivity and specificity of 70–80%.
A specific test for parathyroid adenoma is sestamibi parathyroid scintigraphy, the sestamibi scan. This nuclear imaging technique reveals the presence and location of pathological parathyroid tissue. [7] 4DCT is used as second line investigation to diagnose parathyroid adenoma.
If a patient has elevated calcium, several different types of tests can be used to locate the abnormal glands. The most common and most accurate test to find a parathyroid tumor is the Sestamibi scan. The Sestamibi scan does not have high resolution. Neck ultrasound has higher resolution, but requires some expertise to perform.
A nuclear medicine parathyroid scan demonstrates a parathyroid adenoma adjacent to the left inferior pole of the thyroid gland. The above study was performed with Technetium-Sestamibi (1st column) and iodine-123 (2nd column) simultaneous imaging and the subtraction technique (3rd column).
Technetium-99m (99m Tc) is a metastable nuclear isomer of technetium-99 (itself an isotope of technetium), symbolized as 99m Tc, that is used in tens of millions of medical diagnostic procedures annually, making it the most commonly used medical radioisotope in the world.