Objectives: The aim of this study is to investigate factors that are associated with having a non-localising 99m Tc-sestamibi scan.
Design: A retrospective study was performed on patients that underwent parathyroid surgery performed within a single institution between 2001 and 2018.
Setting: Single tertiary centre for parathyroid surgery.
Participants: 230 patients underwent surgery for primary hyperparathyroidism due to a solitary parathyroid adenoma and had preoperative 99m Tc-sestamibi imaging.
Main outcome measures: Variables including age, gender, intra-operative location of parathyroid adenoma, adenoma weight and pre- and postoperative calcium and parathyroid hormone levels were investigated through univariate and multivariate analysis to identify any association with having a non-localising (negative) 99m Tc-sestamibi scan result.
Results: Multivariate analysis identified that right-sided adenomas (P = .038), superior adenomas (P = .042) and a lower preoperative PTH level (P = .034) were all individual factors associated with having a negative 99m Tc-sestamibi scan result. Although the weight of the adenoma was significant on univariate analysis (P = .029), this was not demonstrated on multivariate analysis (P = .422).
Conclusion: Factors that were associated with having non-localising 99m Tc-sestamibi scan were right-sided adenomas, superior adenomas and lower preoperative PTH level. Further large prospective multicentre studies are needed to further evaluate these initial findings.
Keywords: adenoma/diagnostic imaging; adenoma/surgery; calcium/blood; hyperparathyroidism/surgery; parathyroid hormone/blood; parathyroid neoplasms/surgery; technetium tc 99m sestamibi.
© 2020 John Wiley & Sons Ltd.