EVALUATING A NEGATIVE RESULT OF Tc99m-SESTAMIBI SCAN IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM (PHPT)

Tc99m-sestamibi scan may be negative in a significant percentage of patients with PHPT (15 – 25 %). This may be observed in:

1.Parathyroid hyperplasia (multiglandular disease)

2.Multiple parathyroid adenomas

3.Coexistent thyroid pathology (increases not only false negative but also false positive rate)

4.Treatment with calcium channel blockers (interfering with the uptake of Tc99m by parathyroid cells)

5.Superior location of adenoma

6.Small size of the adenoma

7.Paucity of oxyphil cells within the adenoma

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