New England Surgical Society (NESS)
Search NESS
  Home
  Annual Meeting
  Annual Resident and Fellow Research Day
  Members
      Member Directory
      Members Only
  Scholars Foundation
  Job Board
  Awards
  Journal of the American College of Surgeons
  Newsletters
  Committees
  Contact NESS

NESS 2006 Annual Meeting
Back to Scientific Program
Back to Annual Meeting


What Does a Negative Sestamibi Scan Reveal About Single Parathyroid Adenomas?
Antonia E Stephen, Sanford I Roth, David W Fardo, Dianne M Finkelstein, Gregory W Randolph, Randall D Gaz, Richard A Hodin
Massachusetts General Hospital, Boston, MA

Objective: To investigate why some patients with single parathyroid adenomas have negative pre-operative sestamibi scans.
Design: Retrospective review.
Setting: Tertiary care center.
Patients: Twenty-one patients with false negative (FN) scans were compared to 22 patients with true positive (TP) scans. All patients had single adenomas. Interventions: Neck exploration and removal of parathyroid adenomas.
Main Outcome Measures: Age, sex, calcium and parathyroid hormone levels; gland weight, location, and pathology.
Results: There was no difference in age, calcium, or parathyroid hormone levels. Gland weight was greater in the TP group, compared with the FN group (1336 +/- 1603 mg versus 475 +/- 365 mg (mean +/- stddev); (p = 0.0445). Fourteen of the 21 glands (67%) in the FN group were located in the upper position, compared to 6 of the 22 (27%) glands in the TP group (p = 0.0148). Ten of the 22 glands in the TP group consisted predominantly of oxyphil cells, compared to 2 of the 21 glands in the FN group (p = 0.0157). A multivariate logistic regression model yielded the following factors which predict an accurate scan: higher percentage of oxyphil cells (p = 0.0270), heavier gland (p = 0.0305), female gender (p = 0.0414), and gland location in the lower position (p = 0.0495).
Conclusions: Smaller volume parathyroid adenomas and those in the upper position are less likely to localize on sestamibi scans. A true positive scan correlates with oxyphil cell predominance, supporting a role for the mitochodrial-rich cell in sestamibi uptake and retention.


Back to Scientific Program
Back to Annual Meeting

Copyright © 2018 New England Surgical Society. All Rights Reserved.
Read Privacy Policy.