Double-phase parathyroid scintigraphy in dogs using technetium-99M-sestamibi.

The purpose of this study was to evaluate the utility of double-phase parathyroid scintigraphy using 99mTc-sestamibi for detecting and localizing hyperfunctioning parathyroid glands in hypercalcemic dogs. Fifteen hypercalcemic dogs that underwent parathyroid scintigraphy were included in this study: 3 dogs with hypercalcemia of malignancy, and 12 dogs with hyperfunctioning parathyroid tissue (parathyroid adenoma or parathyroid hyperplasia). The presence of parathyroid adenoma or parathyroid hyperplasia was documented by histopathologic examination. In 3 dogs with hypercalcemia of malignancy, parathyroid scintigraphy was negative for hyperfunctioning parathyroid tissue and the scans were classified as true negative. Parathyroid scintigraphy correctly identified the presence and location of hyperfunctioning parathyroid tissue in only 1 of 6 dogs with a parathyroid adenoma. False positive and false negative results occurred in dogs with parathyroid adenomas. Parathyroid scintigraphy failed to detect hyperfunctioning parathyroid tissue in 5 of 6 dogs with parathyroid hyperplasia and were classified as false negative. False positive results were obtained in the remaining dog with parathyroid hyperplasia. Sensitivity of parathyroid scintigraphy for detecting and localizing hyperfunctioning parathyroid tissue was 11%, specificity was 50%, and overall accuracy was 27%. Positive and negative predictive value were 25% and 27%, respectively. Sensitivity for detection of parathyroid adenomas was 25%, and sensitivity for detection of hyperplastic glands was 0 %. Results of this study indicate that double-phase parathyroid scintigraphy does not appear to have acceptable accuracy in detecting hyperfunctioning parathyroid glands in dogs. Due to the poor sensitivity and specificity of the technique in dogs, parathyroid scintigraphy is not recommended for definitive identification of abnormal parathyroid glands as the cause of hypercalcemia in dogs.

Use of technetium Tc 99m sestamibi for detection of a parathyroid adenoma in a dog with primary hyperparathyroidism.

Double-phase parathyroid gland scintigraphy, using technetium Tc 99m sestamibi, correctly identified the existence and location of a parathyroid adenoma in a dog with primary hyperparathyroidism. The parathyroid adenoma was removed surgically 2 days after scintigraphy. An area of focal radionuclide uptake persisted in the region corresponding to the left external parathyroid gland in the delayed-phase image. Delayed-phase images from 3 healthy dogs and a dog with hypercalcemia of malignancy caused by lymphoma did not reveal an area of persistent radiotracer uptake. Double-phase parathyroid gland scintigraphy, using 99mTc-sestamibi, is a simple, rapid, noninvasive test, which can be used for detection and localization of parathyroid adenomas in hypercalcemic dogs. It also can help to differentiate these dogs from dogs with hypercalcemia of malignancy.