Technetium-99m-Sestamibi Parathyroid Scintigraphy: Effect of P-Glycoprotein, Histology and Tumor Size on Detectability
The purpose of this study was to evaluate the effect of P-glycoprotein (P-gp) levels, predominant histology and tumor size on the detectability of parathyroid adenomas with 99mTc-sestamibi scans. Although previous studies have shown that positivity correlates with tumor size, false-negative studies...
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| Veröffentlicht in: | The Journal of nuclear medicine (1978) 1998-09, Vol.39 (9), p.1617-1620 |
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| creator | Bhatnagar, Anish Vezza, Phyllis R Bryan, John A Atkins, Francis B Ziessman, Harvey A |
| description | The purpose of this study was to evaluate the effect of P-glycoprotein (P-gp) levels, predominant histology and tumor size on the detectability of parathyroid adenomas with 99mTc-sestamibi scans. Although previous studies have shown that positivity correlates with tumor size, false-negative studies have been reported with large tumors and true-positives reported with very small tumors. Recent investigations have reported rapid washout of sestamibi in malignant tumors because of high levels of P-gp, similar to that seen with multidrug chemotherapy resistance. Therefore, we postulated that this mechanism might account for false-negative studies in parathyroid tumors. Preliminary reports have suggested that the predominant histological subtype influences positivity on 99mTc-sestamibi parathyroid scans.
We studied 25 patients with surgically confirmed parathyroid adenomas with 99mTc-sestamibi parathyroid scans. The results of the imaging study were correlated with tissue P-gp levels, predominant histological subtype and size of the surgically removed glands.
There were 21 true-positive and 4 false-negative results. The size of the adenomas ranged from 0.12 to 8.64 ml. We found no correlation between the results of the dual-phase 99mTc-sestamibi study and either the predominant cell type or the level of P-gp. Positivity did correlate with the size of the adenoma (p=0.73, p < 0.0001). We cannot exclude the possibility that P-gp and cell type may still play a role in individual cases, but we suspect that other yet to be determined factors may influence 99mTc-sestamibi detectability in addition to tumor size. |
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We studied 25 patients with surgically confirmed parathyroid adenomas with 99mTc-sestamibi parathyroid scans. The results of the imaging study were correlated with tissue P-gp levels, predominant histological subtype and size of the surgically removed glands.
There were 21 true-positive and 4 false-negative results. The size of the adenomas ranged from 0.12 to 8.64 ml. We found no correlation between the results of the dual-phase 99mTc-sestamibi study and either the predominant cell type or the level of P-gp. Positivity did correlate with the size of the adenoma (p=0.73, p < 0.0001). We cannot exclude the possibility that P-gp and cell type may still play a role in individual cases, but we suspect that other yet to be determined factors may influence 99mTc-sestamibi detectability in addition to tumor size.</description><identifier>ISSN: 0161-5505</identifier><identifier>EISSN: 1535-5667</identifier><identifier>PMID: 9744355</identifier><identifier>CODEN: JNMEAQ</identifier><language>eng</language><publisher>Reston, VA: Soc Nuclear Med</publisher><subject>Adenoma - diagnostic imaging ; Adenoma - metabolism ; Adenoma - pathology ; Adolescent ; Adult ; Aged ; ATP-Binding Cassette, Sub-Family B, Member 1 - metabolism ; Biological and medical sciences ; Endocrine glands. Genital system. Mammary gland ; Endocrinopathies ; False Negative Reactions ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Malignant tumors ; Medical sciences ; Middle Aged ; Parathyroid Glands - diagnostic imaging ; Parathyroid Glands - pathology ; Parathyroid Neoplasms - diagnostic imaging ; Parathyroid Neoplasms - metabolism ; Parathyroid Neoplasms - pathology ; Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases) ; Preoperative Care ; Radionuclide Imaging ; Radionuclide investigations ; Radiopharmaceuticals ; Retrospective Studies ; Technetium Tc 99m Sestamibi</subject><ispartof>The Journal of nuclear medicine (1978), 1998-09, Vol.39 (9), p.1617-1620</ispartof><rights>1998 INIST-CNRS</rights><rights>Copyright Society of Nuclear Medicine Sep 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2381596$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9744355$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhatnagar, Anish</creatorcontrib><creatorcontrib>Vezza, Phyllis R</creatorcontrib><creatorcontrib>Bryan, John A</creatorcontrib><creatorcontrib>Atkins, Francis B</creatorcontrib><creatorcontrib>Ziessman, Harvey A</creatorcontrib><title>Technetium-99m-Sestamibi Parathyroid Scintigraphy: Effect of P-Glycoprotein, Histology and Tumor Size on Detectability</title><title>The Journal of nuclear medicine (1978)</title><addtitle>J Nucl Med</addtitle><description>The purpose of this study was to evaluate the effect of P-glycoprotein (P-gp) levels, predominant histology and tumor size on the detectability of parathyroid adenomas with 99mTc-sestamibi scans. Although previous studies have shown that positivity correlates with tumor size, false-negative studies have been reported with large tumors and true-positives reported with very small tumors. Recent investigations have reported rapid washout of sestamibi in malignant tumors because of high levels of P-gp, similar to that seen with multidrug chemotherapy resistance. Therefore, we postulated that this mechanism might account for false-negative studies in parathyroid tumors. Preliminary reports have suggested that the predominant histological subtype influences positivity on 99mTc-sestamibi parathyroid scans.
We studied 25 patients with surgically confirmed parathyroid adenomas with 99mTc-sestamibi parathyroid scans. The results of the imaging study were correlated with tissue P-gp levels, predominant histological subtype and size of the surgically removed glands.
There were 21 true-positive and 4 false-negative results. The size of the adenomas ranged from 0.12 to 8.64 ml. We found no correlation between the results of the dual-phase 99mTc-sestamibi study and either the predominant cell type or the level of P-gp. Positivity did correlate with the size of the adenoma (p=0.73, p < 0.0001). We cannot exclude the possibility that P-gp and cell type may still play a role in individual cases, but we suspect that other yet to be determined factors may influence 99mTc-sestamibi detectability in addition to tumor size.</description><subject>Adenoma - diagnostic imaging</subject><subject>Adenoma - metabolism</subject><subject>Adenoma - pathology</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>ATP-Binding Cassette, Sub-Family B, Member 1 - metabolism</subject><subject>Biological and medical sciences</subject><subject>Endocrine glands. Genital system. Mammary gland</subject><subject>Endocrinopathies</subject><subject>False Negative Reactions</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Malignant tumors</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parathyroid Glands - diagnostic imaging</subject><subject>Parathyroid Glands - pathology</subject><subject>Parathyroid Neoplasms - diagnostic imaging</subject><subject>Parathyroid Neoplasms - metabolism</subject><subject>Parathyroid Neoplasms - pathology</subject><subject>Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)</subject><subject>Preoperative Care</subject><subject>Radionuclide Imaging</subject><subject>Radionuclide investigations</subject><subject>Radiopharmaceuticals</subject><subject>Retrospective Studies</subject><subject>Technetium Tc 99m Sestamibi</subject><issn>0161-5505</issn><issn>1535-5667</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkEtr3DAUhU1oSSePn1AQpTSbGPSwXt2VNI9CIIGZrI0sS2MNtjSV5Abn10clQxbZ3Ls43z2ce46qFaKE1pQx_qlaQcRQTSmkX6qTlHYQQiaEOK6OJW8aQumq-rcxevAmu3mqpZzqtUlZTa5z4FFFlYclBteDtXY-u21U-2H5Ca6tNTqDYMFjfTsuOuxjyMb5S3DnUg5j2C5A-R5s5ilEsHYvBgQPfptcrlTnRpeXs-qzVWMy54d9Wj3dXG-u7ur7h9s_V7_u6wHLJteaKYU6zbHtZSegKBMKTlCDGsKkYNxgxDprGeR9L3qGmNFENRxTY5mEiJxWP958S8S_c_mtnVzSZhyVN2FOLSeyVIRFAb99AHdhjr5kazGSGMKG4QJ9PUBzN5m-3Uc3qbi0hzaL_v2gq6TVaKPy2qV3DBOBqGQFu3jDBrcdnl00rZ_1aFT877nzE5GtbEssTl4BiOGMHg</recordid><startdate>19980901</startdate><enddate>19980901</enddate><creator>Bhatnagar, Anish</creator><creator>Vezza, Phyllis R</creator><creator>Bryan, John A</creator><creator>Atkins, Francis B</creator><creator>Ziessman, Harvey A</creator><general>Soc Nuclear Med</general><general>Society of Nuclear Medicine</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>19980901</creationdate><title>Technetium-99m-Sestamibi Parathyroid Scintigraphy: Effect of P-Glycoprotein, Histology and Tumor Size on Detectability</title><author>Bhatnagar, Anish ; Vezza, Phyllis R ; Bryan, John A ; Atkins, Francis B ; Ziessman, Harvey A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h294t-c6aa1bc72fd9b808d9b08731414369867e216bff607dd8d616ec3a4725ef69013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adenoma - diagnostic imaging</topic><topic>Adenoma - metabolism</topic><topic>Adenoma - pathology</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>ATP-Binding Cassette, Sub-Family B, Member 1 - metabolism</topic><topic>Biological and medical sciences</topic><topic>Endocrine glands. Genital system. Mammary gland</topic><topic>Endocrinopathies</topic><topic>False Negative Reactions</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Malignant tumors</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Parathyroid Glands - diagnostic imaging</topic><topic>Parathyroid Glands - pathology</topic><topic>Parathyroid Neoplasms - diagnostic imaging</topic><topic>Parathyroid Neoplasms - metabolism</topic><topic>Parathyroid Neoplasms - pathology</topic><topic>Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)</topic><topic>Preoperative Care</topic><topic>Radionuclide Imaging</topic><topic>Radionuclide investigations</topic><topic>Radiopharmaceuticals</topic><topic>Retrospective Studies</topic><topic>Technetium Tc 99m Sestamibi</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhatnagar, Anish</creatorcontrib><creatorcontrib>Vezza, Phyllis R</creatorcontrib><creatorcontrib>Bryan, John A</creatorcontrib><creatorcontrib>Atkins, Francis B</creatorcontrib><creatorcontrib>Ziessman, Harvey A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of nuclear medicine (1978)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhatnagar, Anish</au><au>Vezza, Phyllis R</au><au>Bryan, John A</au><au>Atkins, Francis B</au><au>Ziessman, Harvey A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Technetium-99m-Sestamibi Parathyroid Scintigraphy: Effect of P-Glycoprotein, Histology and Tumor Size on Detectability</atitle><jtitle>The Journal of nuclear medicine (1978)</jtitle><addtitle>J Nucl Med</addtitle><date>1998-09-01</date><risdate>1998</risdate><volume>39</volume><issue>9</issue><spage>1617</spage><epage>1620</epage><pages>1617-1620</pages><issn>0161-5505</issn><eissn>1535-5667</eissn><coden>JNMEAQ</coden><abstract>The purpose of this study was to evaluate the effect of P-glycoprotein (P-gp) levels, predominant histology and tumor size on the detectability of parathyroid adenomas with 99mTc-sestamibi scans. Although previous studies have shown that positivity correlates with tumor size, false-negative studies have been reported with large tumors and true-positives reported with very small tumors. Recent investigations have reported rapid washout of sestamibi in malignant tumors because of high levels of P-gp, similar to that seen with multidrug chemotherapy resistance. Therefore, we postulated that this mechanism might account for false-negative studies in parathyroid tumors. Preliminary reports have suggested that the predominant histological subtype influences positivity on 99mTc-sestamibi parathyroid scans.
We studied 25 patients with surgically confirmed parathyroid adenomas with 99mTc-sestamibi parathyroid scans. The results of the imaging study were correlated with tissue P-gp levels, predominant histological subtype and size of the surgically removed glands.
There were 21 true-positive and 4 false-negative results. The size of the adenomas ranged from 0.12 to 8.64 ml. We found no correlation between the results of the dual-phase 99mTc-sestamibi study and either the predominant cell type or the level of P-gp. Positivity did correlate with the size of the adenoma (p=0.73, p < 0.0001). We cannot exclude the possibility that P-gp and cell type may still play a role in individual cases, but we suspect that other yet to be determined factors may influence 99mTc-sestamibi detectability in addition to tumor size.</abstract><cop>Reston, VA</cop><pub>Soc Nuclear Med</pub><pmid>9744355</pmid><tpages>4</tpages></addata></record> |
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| subjects | Adenoma - diagnostic imaging Adenoma - metabolism Adenoma - pathology Adolescent Adult Aged ATP-Binding Cassette, Sub-Family B, Member 1 - metabolism Biological and medical sciences Endocrine glands. Genital system. Mammary gland Endocrinopathies False Negative Reactions Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Malignant tumors Medical sciences Middle Aged Parathyroid Glands - diagnostic imaging Parathyroid Glands - pathology Parathyroid Neoplasms - diagnostic imaging Parathyroid Neoplasms - metabolism Parathyroid Neoplasms - pathology Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases) Preoperative Care Radionuclide Imaging Radionuclide investigations Radiopharmaceuticals Retrospective Studies Technetium Tc 99m Sestamibi |
| title | Technetium-99m-Sestamibi Parathyroid Scintigraphy: Effect of P-Glycoprotein, Histology and Tumor Size on Detectability |
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