^99mTechnetium Sestamibi-¹²³Iodine Scintigraphy Is More Accurate Than ^99mTechnetium Sestamibi Alone before Surgery for Primary Hyperparathyroidism

Figure 3

Parathyroid -sestamibi-¹²³I-subtraction scintigraphy in a 53-year-old woman with primary hyperparathyroidism (serum ionized calcium 1.58 mmol/l, PTH 201 ng/l). The patient was cured by removal of a 2.0-gram parathyroid adenoma excised at the site predicted in the scintigraphy. First row: early -sestamibi image (left), early ¹²³I image (right). Second row: delayed -sestamibi image (left), delayed ¹²³I image (right). Third row: the subtraction image of delayed -sestamibi and ¹²³I images shows a focal uptake at the inferior pole of left thyroid gland and is seen only in this image.