Preoperative localization of parathyroid adenomas by technetium-thallium and ultrasound imaging
The ability of technetium-thallium and ultrasound imaging to localize parathyroid adenomas was evaluated in a group of 66 patients with biochemical evidence of primary hyperparathyroidism. A 50K count image of the neck was computer acquired with a gamma camera and pinhole collimator 30 minutes after IV injection of 1 mCi of Tc-99m pertechnetate. Without patient movement, 1-2 mCi of T1-201 chloride was injected IV, and sequential 30 second images were acquired for 25 minutes. The thallium images were summed and computer subtraction of the normalized pertechnetate image was performed to identify areas of discordant radionuclide uptake. Ultrasound examination was performed using a static B-mode and/or real-time scanner with a 5 MHz transducer. In the 24 patients who have had surgery to date, nuclear imaging successfully localized 11/23 adenomas with 2 false positives. Ultrasound identified 12/23 adenomas with 5 false positives. The combination of techniques found 16/23 adenomas including 12/12 inferior or mediastinal and 4/11 superior adenomas. Each imaging modality was more successful in identifying inferior than superior adenomas. Nuclear imaging was more sensitive for adenomas projecting beyond the margin of the thyroid, while ultrasound was more sensitive for adenomas posterior to the thyroid. Thus technetium-thallium and ultrasound imaging are complementary, and the combination represents a useful technique for the preoperative localization of parathyroid adenomas.
- Research Organization:
- West Los Angeles V.A. Medical Center, Los Angeles, CA
- OSTI ID:
- 6760504
- Report Number(s):
- CONF-850611-
- Journal Information:
- J. Nucl. Med.; (United States), Journal Name: J. Nucl. Med.; (United States) Vol. 26:5; ISSN JNMEA
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
ADENOMAS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL LOCALIZATION
BODY
BODY AREAS
CAMERAS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
DISTRIBUTION
DRUGS
DUAL-ISOTOPE SUBTRACTION TECHNIQUE
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE GLANDS
GAMMA CAMERAS
GLANDS
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LABELLED COMPOUNDS
NECK
NEOPLASMS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PARATHYROID GLANDS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIONUCLIDE KINETICS
RADIOPHARMACEUTICALS
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
TECHNETIUM 99
TECHNETIUM ISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
THYROID
TISSUE DISTRIBUTION
TRACER TECHNIQUES
ULTRASONOGRAPHY
UPTAKE
YEARS LIVING RADIOISOTOPES