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Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery

Conference · · J. Nucl. Med.; (United States)
OSTI ID:6856096
; ; ;

Parathyroid imaging based on the principle of differential uptakes of Tc-99m and T1-201 in the anterior neck to localize parathyroid (PT) disease has been reported with widely varying results. To evaluate the usefulness of this method, we have performed PT imaging on 47 patients prior to exploratory surgery for PT disease. Using pinhole collimation and digital acquisition, a 50k count image of the thyroid was obtained 20 minutes after injection of 1mCi99m Tc-pertechnetate. Then a lmCi dose of Tl-201 chloride was injected and a series of images acquired for 30 minutes at 30 sec/image. Raw data was spatially filtered and normalized by summing sufficient T1-201 images to equal the Tc-99m image scale of maximum cts/pixel. Image subtraction (Tl-Tc) gave the final PT image. Of 10 pts who had previous neck exploration, all had PT pathology accurately localized by preoperative scanning (7=single adenoma, 2=single hyperplastic gland, 1=two hyperplastic glands). In two causes distant ectopic pathology was localized in the strap muscles of the neck. For the 37 pts without previous surgery, scanning localized 85% of adenomas and 44% of hyperplastic glands with a false positive rate of 17%. Patient motion and coexisting thyroid disease particularly degraded final image quality. The authors conclude that preoperative PT imaging is a valuable aid for localizing pathology in patients who undergo secondary neck exploration but has only limited use for screening primary surgical cases.

Research Organization:
Cleveland Clinic Foundation, Cleveland, OH
OSTI ID:
6856096
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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Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ADENOMAS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BIOLOGICAL LOCALIZATION
BODY
BODY AREAS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DISTRIBUTION
DRUGS
DUAL-ISOTOPE SUBTRACTION TECHNIQUE
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE GLANDS
GLANDS
HEAVY NUCLEI
HOURS LIVING RADIOISOTOPES
IMAGES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LABELLED COMPOUNDS
MEDICINE
NECK
NEOPLASMS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PARATHYROID GLANDS
PATHOLOGY
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIONUCLIDE KINETICS
RADIOPHARMACEUTICALS
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SURGERY
TECHNETIUM 99
TECHNETIUM ISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
THYROID
TISSUE DISTRIBUTION
TRACER TECHNIQUES
UPTAKE
YEARS LIVING RADIOISOTOPES