EXPERIENCE WITH PARATHYROID SCINTIGRAPHY

After a short review of the actual possibilities of parathyroid visualization with radioisotopes, the authors refer to their experience using Se⁷⁵-selenomethionine; such experience extends to 34 patients suffering from primary hyperparathyroidism, of whom 15 have been controlled surgically. Preoperative exact localization of hyperfunctioning parathyroid tissue has been achieved in 53 per cent of the controlled patients.

Biologic and physical factors, affecting the visualization of parathyroid tissue, are discussed. These factors are:

1. The functional condition of the gland. As the methionine content of the metabolically active polypeptides is low, parathyroid tissue must display a high uptake of the labelled aminoacid.

2. The size and the site of the pathologic tissue. The larger the adenoma the easier its visualization; the site is important because the superimposition of the thyroid gland and bone marrow may disturb the visualization of parathyroid tissue.

3. The inhibition of the thyroid. The functional suppression of the thyroid increases the possibilities of positive parathyroid scans, owing to the close topographic connection between the 2 glands.

4. The technical conditions of detection. These must be optimized, employing high efficiency scanner with an enhanced contrast recording system; the use of serial scans with superimposition of one on the other finally increases the diagnostic accuracy.

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