Table of Contents
International Journal of Molecular Imaging
Volume 2013, Article ID 921260, 12 pages
Clinical Study

Comparison of Five Parathyroid Scintigraphic Protocols

1Department of Nuclear Medicine, Satakunta Central Hospital, Sairaalantie 3, 28500 Pori, Finland
2Department of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital, HUS, P.O. Box 340, 00029 Helsinki, Finland
3HUS Medical Imaging Center, Helsinki University Central Hospital, P.O. Box 340, 00029 Helsinki, Finland
4Turku PET Centre, Turku University Hospital, P.O. Box 52, 20521 Turku, Finland
5Department of Biomedical Engineering, Tampere University of Technology, P.O. Box 527, 33101 Tampere, Finland
6Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, P.O. Box 52, 20521 Turku, Finland

Received 25 October 2012; Revised 23 December 2012; Accepted 27 December 2012

Academic Editor: Francesca Pons

Copyright © 2013 Virpi Tunninen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. We compared five parathyroid scintigraphy protocols in patients with primary (pHPT) and secondary hyperparathyroidism (sHPT) and studied the interobserver agreement. The dual-tracer method ( c-sestamibi/123I) was used with three acquisition techniques (parallel-hole planar, pinhole planar, and SPECT/CT). The single-tracer method ( c-sestamibi) was used with two acquisition techniques (double-phase parallel-hole planar, and SPECT/CT). Thus five protocols were used, resulting in five sets of images. Materials and Methods. Image sets of 51 patients were retrospectively graded by four experienced nuclear medicine physicians. The final study group consisted of 24 patients (21 pHPT, 3 sHPT) who had been operated upon. Surgical and histopathologic findings were used as the standard of comparison. Results. Thirty abnormal parathyroid glands were found in 24 patients. The sensitivities of the dual-tracer method (76.7–80.0%) were similar ( ). The sensitivities of the single-tracer method (13.3–31.6%) were similar ( ). All differences in sensitivity between these two methods were statistically significant ( ). The interobserver agreement was good. Conclusion. This study indicates that any dual-tracer protocol with c-sestamibi and 123I is superior for enlarged parathyroid gland localization when compared with single-tracer protocols using c-sestamibi alone. The parathyroid scintigraphy was found to be independent of the reporter.