Endocrinology and Metabolism

Original Articles

Clinical Study
Radioactive Parathyroid Adenomas on Sestamibi Scans: Low Parathyroid Hormone Secretory Potential and Large Volume: Sung Hye Kong, Jung Hee Kim, Sang Wan Kim, Chan Soo Shin; Endocrinol Metab. 2021;36(2):351-358. Published online April 6, 2021; DOI: https://doi.org/10.3803/EnM.2020.823

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Background
We investigated the clinical characteristics of parathyroid adenomas according to radioactivity on ^99mTc-methoxyisobutylisonitrile (^99mTc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) in primary hyperparathyroidism (PHPT) patients.
Methods
The study included 217 patients diagnosed with PHPT from 2000 to 2019 at Seoul National University Hospital who underwent ^99mTc-MIBI SPECT/CT scans. On SPECT/CT, the radioactivity of parathyroid adenomas was measured as the ratio of the mean radioactivity count of the parathyroid adenoma to that of the contralateral thyroid.
Results
Tumors were localized by MIBI scans in 190 patients (MIBI [+] group) and by ultrasound or parathyroid four-dimensional CT in 27 patients (MIBI [–] group). The mean age was 55 years, and mean body mass index was 23.4 kg/m². Patients in the MIBI (+) group had higher parathyroid hormone (iPTH) and lower 25-hydroxy vitamin D levels than those in the MIBI (–) group (168.0 pg/mL [interquartile range, IQR, 111.0 to 250.7] vs. 134.7 pg/mL [IQR, 98.2 to 191.2], P=0.049; 15.4 ng/mL [IQR, 11.1 to 20.8] vs. 21.2 ng/mL [IQR, 13.9 to 24.8], P=0.012, respectively). Patients in the MIBI (+) group had larger tumor volumes, but lower iPTH/volume ratios than those in the MIBI (–) group (1,216.66 [IQR, 513.40 to 2,663.02], 499.82 mm³ [IQR, 167.77 to 1,229.80], P=0.002; 0.18 [IQR, 0.08 to 0.46], 0.40 pg/mL/mm³ [IQR, 0.16 to 1.29], P=0.016, respectively). Adenoma radioactivity was positively correlated with calcium, iPTH, and volume (r=0.180, P=0.020; r=0.208, P=0.006; r=0.288, P<0.001, respectively), but not with iPTH/volume.
Conclusion
Parathyroid adenomas with positive MIBI scans had larger volumes and higher iPTH than adenomas with negative scans, but lower iPTH per unit volume.

Citations

Citations to this article as recorded by

Protein Signatures of Parathyroid Adenoma according to Tumor Volume and Functionality
Sung Hye Kong, Jeong Mo Bae, Jung Hee Kim, Sang Wan Kim, Dohyun Han, Chan Soo Shin
Endocrinology and Metabolism.2024; 39(2): 375. CrossRef
Atypical parathyroid tumor: clinical and parathyroid hormone response to surgical treatment
Antonio Giulio Napolitano, Massimo Monacelli, Valeria Liparulo, Eleonora Coviello, Domenico Pourmolkara, Stefano Avenia, Andrea Polistena
Annals of Surgical Treatment and Research.2023; 105(2): 76. CrossRef
The Relationship between Planar and SPECT/CT Parameters and Functional Markers in Primary Hyperparathyroidism
Guler Silov, Serpil Erdogan Ozbodur
Diagnostics.2023; 13(20): 3182. CrossRef

Thyroid
Diagnostic Whole-Body Scan May Not Be Necessary for Intermediate-Risk Patients with Differentiated Thyroid Cancer after Low-Dose (30 mCi) Radioactive Iodide Ablation: Eon Ju Jeon, Eui Dal Jung; Endocrinol Metab. 2014;29(1):33-39. Published online March 14, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.1.33

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32 Download
10 Web of Science
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Abstract PDF PubReader

Background

A diagnostic whole-body scan (WBS) is recommended 6 to 12 months after total thyroidectomy and radioactive iodide ablation in intermediate- or high-risk patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate the necessity of a diagnostic WBS after radioactive iodide ablation in intermediate-risk patients with DTC.

Methods

A total of 438 subjects were included in the study: 183 low-risk subjects and 255 intermediate-risk subjects according to the American Thyroid Association guideline. All subjects diagnosed with DTC received 1,100 MBq (30 mCi) activity of radioiodine (I-131) following total thyroidectomy. On follow-up, all subjects underwent a diagnostic I-131 WBS after thyroid hormone withdrawal.

Results

After initial radioactive iodide ablation, 95.1% of low-risk patients and 91.4% of intermediate-risk patients showed no uptake on diagnostic WBS (P=0.135). Intermediate-risk patients with stimulated thyroglobulin (Tg) levels higher than 2.0 ng/mL showed a greater rate of radioactive iodine uptake on diagnostic WBS. Four intermediate-risk patients showed recurrence during the 16 to 80 months follow-up period. Three of the four patients with recurrence showed no uptake on diagnostic WBS and had a stimulated Tg level less than 2.0 ng/mL.

Conclusion

A diagnostic I-131 WBS after radioactive iodide ablation in intermediate-risk patients with DTC may not be necessary. A large prospective study is necessary to determine the necessity of diagnostic WBS in intermediate-risk patients with DTC.

Citations

Citations to this article as recorded by

Long-Term Prognostic Value of the Response to Therapy Assessed by Laboratory and Imaging Findings in Patients with Differentiated Thyroid Cancer
Michele Klain, Emilia Zampella, Leandra Piscopo, Fabio Volpe, Mariarosaria Manganelli, Stefania Masone, Leonardo Pace, Domenico Salvatore, Martin Schlumberger, Alberto Cuocolo
Cancers.2021; 13(17): 4338. CrossRef
Lack of Efficacy of Radioiodine Remnant Ablation for Papillary Thyroid Microcarcinoma: Verification Using Inverse Probability of Treatment Weighting
Hyemi Kwon, Min Ji Jeon, Won Gu Kim, Suyeon Park, Mijin Kim, Tae Yong Kim, Minkyu Han, Dong Eun Song, Tae-Yon Sung, Jong Ho Yoon, Suck Joon Hong, Jin-Sook Ryu, Young Kee Shong, Won Bae Kim
Annals of Surgical Oncology.2017; 24(9): 2596. CrossRef
Evaluation of 131I scintigraphy and stimulated thyroglobulin levels in the follow up of patients with DTC: a retrospective analysis of 1420 patients
Jose Manuel Gonzalez Carvalho, Dennis Görlich, Otmar Schober, Christian Wenning, Burkhard Riemann, Frederik Anton Verburg, Alexis Vrachimis
European Journal of Nuclear Medicine and Molecular Imaging.2017; 44(5): 744. CrossRef
Low- and high-dose radioiodine therapy for low-/intermediate-risk differentiated thyroid cancer: a preliminary clinical trial
Yuan Qu, Rui Huang, Lin Li
Annals of Nuclear Medicine.2017; 31(1): 71. CrossRef
ENDOCRINE TUMOURS: Imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach
Livia Lamartina, Désirée Deandreis, Cosimo Durante, Sebastiano Filetti
European Journal of Endocrinology.2016; 175(5): R185. CrossRef
The risk of second primary malignancy is increased in differentiated thyroid cancer patients with a cumulative 131I dose over 37 GBq
Ah Reum Khang, Sun Wook Cho, Hoon Sung Choi, Hwa Young Ahn, Won Sang Yoo, Kyung Won Kim, Keon Wook Kang, Ka Hee Yi, Do Joon Park, Dong Soon Lee, June‐Key Chung, Bo Youn Cho, Young Joo Park
Clinical Endocrinology.2015; 83(1): 117. CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef
Recent Changes in the Clinical Outcome of Papillary Thyroid Carcinoma With Cervical Lymph Node Metastasis
Min Ji Jeon, Won Gu Kim, Yun Mi Choi, Hyemi Kwon, Dong Eun Song, Yu-Mi Lee, Tae-Yon Sung, Jong Ho Yoon, Suck Joon Hong, Jung Hwan Baek, Jeong Hyun Lee, Jin-Sook Ryu, Tae Yong Kim, Young Kee Shong, Ki-Wook Chung, Won Bae Kim
The Journal of Clinical Endocrinology & Metabolism.2015; 100(9): 3470. CrossRef
Letter: Diagnostic Whole-Body Scan May Not Be Necessary for Intermediate-Risk Patients with Differentiated Thyroid Cancer after Low-Dose (30 mCi) Radioactive Iodide Ablation (Endocrinol Metab 2014;29:33-9, Eon Ju Jeon et al.)
Chan-Hee Jung
Endocrinology and Metabolism.2014; 29(2): 206. CrossRef

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