Charles M. Intenzo MD, Presenter: Nothing to Disclose

John Kairys MD, Abstract Co-Author: Nothing to Disclose

Edmund Pribitkin MD, Abstract Co-Author: Nothing to Disclose

Arnold Baskies MD, Abstract Co-Author: Nothing to Disclose

Stacey Milan MD, Abstract Co-Author: Nothing to Disclose

Sung M. Kim MD, Abstract Co-Author: Nothing to Disclose

David Capuzzi MD, Abstract Co-Author: Nothing to Disclose

Tc-99m sestamibi (MIBI) scintigraphy is commonly utilized for the preoperative location of parathyroid adenomas. A focal area of tracer retention that persists on delayed images is fairly specific for a parathyroid adenoma.  Occassionally, there are 2 foci of MIBI retention on delayed imaging, which theorectically suggests a double parathyroid adenoma.  Our aim was to determine just how often this finding was shown to represent a double adenoma. 

Over a 4-year interval, all parathyroid scans with the finding of 2 areas of MIBI concentration in initial images of the neck, that retained the tracer on 3-hour delayed images were collected and corresponding  histopathological results were reviewed.

A total of 16 patients demonstrated the above finding.  Of these, 14 underwent neck exploration; 12 were diagnosed as having asymmetric parathyroid gland hyperplasia, while only 2 were diagnosed with double parathyroid adenoma.

Of the group of 14 patients whose parathyroid scintigraphy showed 2 areas of MIBI retention on 3-hour delayed images of neck, 12 (85.7%) had asymmetric parathyroid hyperplasia, whereas only 2 patients with this finding had true double adenoma..

In parathyroid scintigraphy, 2 foci of tracer retention more than likely indicate parathyroid gland hyperplasia, as opposed to double parathyroid adenoma.

Intenzo, C, Kairys, J, Pribitkin, E, Baskies, A, Milan, S, Kim, S, Capuzzi, D, Does the Finding of Two Foci of Tc-99m Sestamibi Retention on Parathyroid Scintigraphy Necessarily Indicate Double Parathyroid Adenoma?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13020420.html