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Dual phase 99mTc-MIBI planar scintigraphy of parathyroid glands. On the left: early phase (after 10 minutes post injection of tracer) - showing nonspecific uptake in thyroid and parathyroid glands. On the right: late phase (after 120 min) - wash-out of activity from thyroid and retention in three hyperfunctioning parathyroid glands (two inferior and left superior), one gland (right superior) is not visible.
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Planar images (Figure 1) revealed three out of four parathyroid glands depicted in SPECT/CT.
Two images of late phase 99mTc-MIBI SPECT/CT clearly visualizing tracer retention in two inferior (A) and two superior (B) hyperactive parathyroid glands.
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Moreover, SPECT/CT provided additional information about anatomic localization of glands: superior parathyroids were situated behind the mid-lower parts of thyroid lobes, close to the esophagus (Figure 2A), while inferior glands - near the lower poles of thyroid lobes, close to the trachea (Figure 2B).
SPECT/CT and CT alone of the same cross-section, showing left inferior parathyroid. The best diagnostic performance is achieved by combination of detailed morphological image (CT) and functional, scintigraphic map (SPECT/CT).
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Left inferior parathyroid gland is also presented on cross-section images (Figure 3A, 3B).
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