• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.395-398
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• 1997

Whole body $^{99m}Tc-MIBI$ scan in conjunction with parathyroid scan is an effective method in detecting parathyroid lesions in patients with bone pain and possible bone lesions such as brown tumors.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.76-80
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• 2009

Purpose: The uptake of $^{99m}Tc$-MIBI increases in the parathyroid adenoma, hyperplasia, and carcinoma. The purpose of this study is to evaluate and compare the results of the biopsy with quantitative analysis results in the localized parathyroid lesions (adenoma, hyperplasia, and carcinoma). Materials and Methods: From April 2002 to January 2009, double-phase $^{99m}Tc$-MIBI parathyroid scan (early 15 min, delayed 2 hrs) was performed after injection of 750 MBq of $^{99m}Tc$-MIBI in 27 diagnosed parathyroid patients (adenoma:15, hyperplasia:4, carcinoma:8). For quantitative analysis, early, delayed lesion to non-lesion ratios (L/NLs), washout rate (%, WR) and vertical axis were calculated. Results: In early images, lesion to non-lesion ratios were $1.53{\pm}0.41$ (adenoma), $1.38{\pm}0.27$ (hyperplasia) and $1.45{\pm}0.64$ (carcinoma). In delayed images, lesion to non-lesion ratios were $1.56{\pm}0.43$ (adenoma), $1.33{\pm}0.10$ (hyperplasia), $1.83{\pm}0.79$ (carcinoma). In vertical axis, the sizes were $2.11{\pm}0.67$ (adenoma), $2.23{\pm}0.75$ (hyperplasia) and $2.20{\pm}0.97$ (carcinoma). There was no statistical difference between lesion to non-lesion ratios and the size of vertical axis (p>0.05). However, washout rates were $31.59{\pm}13.97$ (adenoma), $37.8{\pm}5.69$ (hyperplasia), $17.73{\pm}11.02$ (carcinoma). As a result, there was a significant difference statistically between and that of carcinoma (p<0.05, p=0.028 by Kruskal-willis statistic, Dunn's Multiple comparison test SPSS Ver 12.0). Conclusions: There was no statistical difference between the lesion to non-lesion ratios and the size of vertical axis. However, there was a significant difference statistically between WR of hyperplasia and that of carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.27-30
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• 2023

A 65-year-old patient who underwent total thyroidectomy 10 years ago was suspected of having a parathyroid adenoma, and minimally invasive parathyroidectomy was planned. Preoperative ultrasonography(USG) and 99mTc MIBI scan indicated a left lower parathyroid lesion. In the first operation, intraoperative parathyroid hormone monitoring (IOPTH) was not possible due to hospital circumstances. Although no adenomatous lesion was found in the expected surgical field, surgery was completed after removing lesions around the left lower parathyroid gland. However, post-surgery, parathyroid hormone did not decrease at all, so a second operation was performed with IOPTH preparation. In the second operation, intraoperative ultrasonography was performed, and a suspected adenoma lesion was removed from the left upper lesion. He has been under follow-up for 3 years without complications. Surgeon-peformed intraoperative USG and preoperative scintigraphy had advantages in determining the localization of parathyroid lesion even withiout IOPTH.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.525-532
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• 1999

The parathyroid hormone related protein (PTHrP) is the most common causative peptide of humoral hypercalcemia of malignancy. In contrast, the serum level of parathyroid hormone (PTH) is low to undetectable in the majority of patients with malignancy associated hypercalcemia. Few cases exist in which the production and secretion of PTH by malignant nonparathyroid tumors have been authenticated. To our knowledge, there is very rare case in which a nonparathyroid tumor expressed simultaneously both the PTH and PTHrP. We report a case of squamous cell carcinoma of the lung with hypercalcemia which presented with simultaneous elevation of serum PTH and PTHrP. Severe hypercalcemia (serum calcium, 7.5 mEq/L) was found in a 65-year-old man who had a squamous cell carcinoma of the lung without any bony metastasis and detectable parathyroid abnormalities on isotope scintigraphy. The serum level of intact parathyroid hormone (PTH) con centration was markedly elevated as measured in two site radioimmunoreactive PTH assays (intact PTH 150 pg/mL ; normal 9~55). The serum level of a PTHrP was also increased as measured in C-terminal region specific radioimmunoassay (PTHrP 99.1 pmol/L; normal 13.8~55.3). There are no evidences of coincidental primary hyperparathyroidism in parathyroid MIBI scan and other imaging studies including neck ultrasonography and computed tomography. These results suggest that simultaneous elevation of serum PTH and PTHrP in this patient can be caused by production of both PTHrP and PTH in other nonparathyroid lesions such as squamous cell carcinoma.