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J Nucl Med. 2008; 49 (Supplement 1):86P
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General Clinical Specialties: Endocrinology

Updates on Parathyroid Imaging

MIBI scan predicts efficacy of percutaneous ethanol injection in hyperparathyroidism

Kunihiro Nakada1, Masayuki Sakurai1, Keiichi Kamijyou2 and Youko HIda3

1 Hokko Memorial Hospital, Sapporo, Hokkaido, Japan; 2 Kamijyo Clinic, Sapporo, Japan; 3 Hokkaido University Hospital, Sapporo, Japan

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Objectives: Percutaneous ethanol injection(PEI) is a possible alternative to surgery for selected patients witrh hyperparathyroidism (HPT). Aim of the study was to assess value of MIBI scan in predicting therapeutic outcome of PEI in HPT.

Methods: Seventeen patients with HPT (age 29-79 yrs. serum Ca (mg/dl): 10.1-12.9, Intact PTH (pg/ml): 84-560, diameter of gland (mm): 4-37), who were high risk for surgery or who refused surgery, were treated by ultrasound(US) -guided PEI, All patients gave written informed consent prior to treatment. All patients underwent Tc-99m MIBI scan prior to treatment. Early and delayed scan images were acquired using dual head gamma camera system equipped with LEHR collimator. PEI was done in a fractioned session. When blood flow in the enlarged gland became undetectable , MIBI scan was done again to determine whether ablation of parathyroid completed or not. Complete disappearance of MIBI uptake was regarded as an end-point of PEI session. If uptake was persistent, additional injection was done. Three months following completion of PEI, therapeutic outcome was judged on basis of serum levels of Ca and i-PTH.

Results: Pretreatment MIBI was positive in 16 of 17 patients (90%). One small gland with 4 mm in diameter was missed. On the post treatment MIBI scan, uptake in the treated gland was disappeared in all 16 patients. At 3 months following PEI, serum levels of Ca as well as i-PTH were normalized in all but one patients (94%). During further follow up of 7-53 months, recurrence of HPT was noted only in 1. Positive predictive value of MIBI scan for long-term success of PEI was88% (14/16).

Conclusions: MIBI scan has high predictive value for theraputic outcome of PEI in HPT. With use of MIBI scan, value of PEI in HPT may be enhanced.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Nakada, K.
Right arrow Articles by HIda, Y.
PubMed
Right arrow Articles by Nakada, K.
Right arrow Articles by HIda, Y.