Treatment with oral biphosphonates can increase the sensitivity of sestamibi radionuclide imaging in patients with primary hyperparathyroidism
| Autor: | Polyzois Makras, Ga, Kaltsas, Athanasoulis T, Papadogias D, Gn, Zografos, Kontogeorgos G, Borboli N, Piaditis G |
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| Předmět: |
Adenoma
Male Parathyroidectomy Technetium Tc 99m Sestamibi Hyperplasia Alendronate Hyperparathyroidism Middle Aged Sensitivity and Specificity Phosphates Parathyroid Glands Parathyroid Neoplasms Parathyroid Hormone Humans Minimally Invasive Surgical Procedures Calcium Female Prospective Studies Radionuclide Imaging Aged |
| Zdroj: | Europe PubMed Central |
| Popis: | The sensitivity of 99mTc-sestamibi scan in detecting parathyroid disease in primary hyperparathyroidism (PHP) is almost 90%, and therefore facilitates successful parathyroidectomy. To enhance the diagnostic accuracy of the procedure, we repeated imaging with 99mTc-sestamibi in 15 patients with PHP and an initially negative (11 patients) or weakly positive (four patients) 99mTc-sestamibi scan after the administration of 10 mg of oral alendronate for 2 months. Serum calcium, phosphate and parathormone (PTH) measurements were obtained at presentation and after 1 and 2 months' treatment with alendronate. Eight patients with an initially negative 99mTc-sestamibi scan demonstrated at least one area of uptake in the repeated scan. Six of these patients underwent surgery and obtained a biochemical cure; a single adenoma was found in four and hyperplasia in the remaining two. In all four patients with an initially weakly positive 99mTc-sestamibi scan, the repeated scan demonstrated enhanced uptake and also revealed further areas of uptake. Two of these patients underwent surgery with a biochemical cure; an adenoma was found in one and hyperplasia in another. Compared with baseline there was a significant increase in PTH but not in calcium or phosphate levels during treatment with alendronate. We suggest that, in patients with PHP and a negative or weakly positive initial 99mTc-sestamibi scan, administration of oral alendronate may be associated with a positive repeated 99mTc-sestamibi scan and can thus enhance the sensitivity of the procedure. |
| Databáze: | OpenAIRE |
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