Imaging of hyperparathyroidism: Comparing combined technetium-99m sestamibi/high-resolution ultrasound with technetium-99m sestamibi or high-resolution ultrasound alone

Abstract

Objective. Ultrasound (US) and technetium-99m sestamibi scintigraphy (MIBI) are frequently used to detect abnormal parathyroid glands in hyperparathyroidism, as this allows the option of minimally invasive parathyroidectomy. This retrospective study compares US, MIBI and combined MIBI/US for detecting uni- and multiglandular disease of the parathyroid. Material and methods. A total of 29 patients with biochemically proven hyperparathyroidism were evaluated. Each parathyroid focus was considered individually. Comparison was made with histopathology. Results. When all cases were considered, combined MIBI/US imaging was significantly superior in terms of excluding parathyroid abnormality to either US or MIBI alone. When only uniglandular disease was considered, MIBI/US was again found to be superior. There was no statistical difference between techniques in terms of excluding multiglandular disease. When all cases were considered, both MIBI/US and MIBI were superior in terms of positively diagnosing unigland...