Sandbox:ap
| Factors influencing sensitivity of Tc-99m sestamibi scintigraphy | ||
|---|---|---|
| Factors | Sensitivity | |
| Biochemical factors | High serum calcium level[1] | Increased |
| High serum parathyroid hormone level[1][2] | Increased | |
| Hypovitaminosis D [3]
(only in primary hyperparathyroidism) |
Increased | |
| Calcium channel blocker use[4]
(only in primary hyperparathyroidism) |
Decreased | |
| Gross and architectural factors | Size (Large)[5][6] | Increased |
| Multi-glandular disease[7] | Decreased | |
| Cytological factors | Increased amount of cellular content[5][6]
(Chief cells and oxyphil cells) |
Increased |
| Immunohistochemical factors | Increased P-glycoprotien expression[8] | Decreased |
| Note: P-glycoprotein (Pgp) is a plasma membrane protein encoded by mammalian multidrug resistance gene (MDRI). Many drugs that are lipophilic and cationic at physiological pH interact with P-gp. Sestamibi is a lipophilic cationic on physioligical pH. P-gp acts as ATP-dependent efflux pump and prevents accumulation of sestamibi in parathyroid tissue. So, the uptake of sestamibi into parathyroid adenoma cells depends on the activity of the P-gp[9]. | ||
- ↑ 1.0 1.1 Parikshak M, Castillo ED, Conrad MF, Talpos GB (2003). "Impact of hypercalcemia and parathyroid hormone level on the sensitivity of preoperative sestamibi scanning for primary hyperparathyroidism". Am Surg. 69 (5): 393–8, discussion 399. PMID 12769210.
- ↑ Siegel A, Alvarado M, Barth RJ, Brady M, Lewis J (2006). "Parameters in the prediction of the sensitivity of parathyroid scanning". Clin Nucl Med. 31 (11): 679–82. doi:10.1097/01.rlu.0000242212.23936.a7. PMID 17053383.
- ↑ Kandil E, Tufaro AP, Carson KA, Lin F, Somervell H, Farrag T; et al. (2008). "Correlation of plasma 25-hydroxyvitamin D levels with severity of primary hyperparathyroidism and likelihood of parathyroid adenoma localization on sestamibi scan". Arch Otolaryngol Head Neck Surg. 134 (10): 1071–5. doi:10.1001/archotol.134.10.1071. PMID 18936353.
- ↑ Friedman K, Somervell H, Patel P, Melton GB, Garrett-Mayer E, Dackiw AP; et al. (2004). "Effect of calcium channel blockers on the sensitivity of preoperative 99mTc-MIBI SPECT for hyperparathyroidism". Surgery. 136 (6): 1199–204. doi:10.1016/j.surg.2004.06.047. PMID 15657576.
- ↑ 5.0 5.1 Mehta NY, Ruda JM, Kapadia S, Boyer PJ, Hollenbeak CS, Stack BC (2005). "Relationship of technetium Tc 99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue". Arch Otolaryngol Head Neck Surg. 131 (6): 493–8. doi:10.1001/archotol.131.6.493. PMID 15967881.
- ↑ 6.0 6.1 Takebayashi S, Hidai H, Chiba T, Takagi Y, Nagatani Y, Matsubara S (1999). "Hyperfunctional parathyroid glands with 99mTc-MIBI scan: semiquantitative analysis correlated with histologic findings". J Nucl Med. 40 (11): 1792–7. PMID 10565772.
- ↑ Haciyanli M, Lal G, Morita E, Duh QY, Kebebew E, Clark OH (2003). "Accuracy of preoperative localization studies and intraoperative parathyroid hormone assay in patients with primary hyperparathyroidism and double adenoma". J Am Coll Surg. 197 (5): 739–46. doi:10.1016/S1072-7515(03)00676-8. PMID 14585407.
- ↑ Gupta Y, Ahmed R, Happerfield L, Pinder SE, Balan KK, Wishart GC (2007). "P-glycoprotein expression is associated with sestamibi washout in primary hyperparathyroidism". Br J Surg. 94 (12): 1491–5. doi:10.1002/bjs.5882. PMID 17929232.
- ↑ Piwnica-Worms D, Chiu ML, Budding M, Kronauge JF, Kramer RA, Croop JM (1993). "Functional imaging of multidrug-resistant P-glycoprotein with an organotechnetium complex". Cancer Res. 53 (5): 977–84. PMID 8094997.