Parathyroid: Single Isotope

  • Detection and Localization of primary or secondary parathyroid adenomas
  • Localization of cancer for surgical candidates
  • Identification of single adenomas, multiple adenomas, or glandular hyperplasia
  • localization of parathyroid tissue post surgery

  • Patient on medication: Calcium or Thyroid (off for at least 5 days)
  • Received Iodine Contrast study in the last 7-10 days
  • Patient is unable to lay still
Radiopharmaceutical information:
  • Radionuclide: Tc-99m
  • Radiopharmaceutical: Sestamibi
  • Adult dosing: (16-30 mCi) generally 20mCi (740MBq)
  • Method of administration: IV
  • Method of Localization: Passive Transport
  • Physical Half-life: 6 hours

Patient Preparation: None

Equipment Used:
Collimator used: LEHR
pinhole-5mm aperture
20 % window centered at 140 KeV

Acquisition Setup:

Statics: View(s)
Matrix: 128x128x16 or 64x64x16
Total Counts or Duration: 1000k counts or 300-900 seconds/image

non-circular orbit
360 degrees
Total Rotation: 360
Starting point: centered on ROI
Matrix: 128x128
Time/Azmuiths: 20-25 sec/stop
Number of stops: 64


There are no instructions regarding patient preparation, the patient arrives, and you will explain the study and that they should plan on it taking approximately 2 and a half hours. You will inject the radiopharmecutical IV and begin the early scans at 20 minutes post injection and then wait 2-4 hours and begin the second scans. The patient should be positioned supine with the chin up and next extended. @ 20 mins post injection acquire planar images w/128x128 matrix, for 1000k counts or 300-900 seconds per image, photopeak @ 140 KeV, 20% window. Acquire an anterior with markers placed at the chin and supersternal notch, and anterior without markers, and a pinhole anterior. For the LEHR images image from the heart and up. At the 2-4 hours post-injection images, repeat the planar images done, and include LEHR RAO and LAO. For SPECT imaging, patient should be positioned supinely as well.

Normal Uptake and common variants:
Insert an image of a normal scan. Describe the normal uptake, and any normal variants visualized.
Elderly man with hyperparathyroidism remains hyperparathyroid after going trying a parathyroidectomy.

Abnormal Uptake and causes:
Insert an image of an abnormal scan. Describe the abnormal uptake, and the cause of the abnormal uptake.

This image depicts a parathyroid adenoma in the left inferior parathyroid.
Insert an image with an artifact, and explain what the artifact is.
The artifact in this scan is the uptake along the injected vein is in the FOV.

Questions asked in Patient History:
List the common questions asked when taking a patient history for this specific procedure.
  1. Does your family have a history of cancer/thyroid disease?
  2. Are you taking any thyroid medication or anything that contains iodine?
  3. Are there swelling and lumps in your neck?
  4. Have you notice any weight changes?
  5. Do you feel uncomfortable in any way?
  6. Have you had any other related tests such as x-rays?
  7. Are you taking any medications with iodine?
  8. Have you had any abnormal blood test results?
  9. Are you pregnant or breastfeeding?
  10. Are you allergic to any food or medications?