Clinical or subclinical hyperparathyroidism is one of the most common endocrine disorders. Excessive secretion of parathyroid hormone is most frequently caused by an adenoma of >or=1 parathyroid gland. Unsuccessful surgery with persistent hyperparathyroidism, due to inadequate preoperative or intraoperative localization, may be observed in about 10% of patients. The conventional surgical approa...

BACKGROUND In patients with known or suspected coronary artery disease, diagnosis and risk stratification can be aided by non-invasive tests for myocardial ischaemia. The main indications for the use of radionuclide perfusion imaging (sestamibi) rather than exercise electrocardiography include complete left bundle branch block, inconclusive stress electrocardiography and an inability to exercis...

OBJECTIVES To assess the impact of rest sestamibi scanning on emergency physicians' (EPs') diagnostic certainty and decision making (as assessed by the hypothetical disposition of patients) for 69 consenting stable patients with suspected acute cardiac ischemia and nondiagnostic electrocardiograms. The resultant impact on costs was examined as a secondary outcome. METHODS Patients with suspec...

UNLABELLED Gated SPECT recorded with 16 intervals determines left ventricular (LV) ejection fraction more accurately than does gated SPECT recorded with 8 intervals but produces higher image noise. This study aimed to assess the results from sestamibi and (201)Tl 16-interval gated SPECT when both signal-to-noise ratio and spatial resolution were enhanced with an original method of reconstructio...

OBJECTIVE To assess the value of preoperative sestamibi scanning and intraoperative parathyroid hormone (IOPTH) measurement in the treatment of patients with primary hyperparathyroidism due to multiple gland disease (MGD). DESIGN Retrospective medical record review. SETTING Tertiary care academic medical center. PATIENTS The study population comprised 383 consecutive patients who underwen...

BACKGROUND Patients who have chest pain without electrocardiographic ST elevation are not candidates for thrombolytic therapy in most clinical trials. This study examined the value of technetium-99m-Sestamibi tomographic imaging to assess myocardial perfusion in patients during chest pain without ST elevation. METHODS AND RESULTS Tc-99m-Sestamibi was injected in 14 patients who had chest pain...

Tc-99m sestamibi is a substrate of P-glycoprotein (Pgp) that has been proposed for use as a functional imaging agent for the multidrug resistance-1 phenotype. In vitro, retention of sestamibi by cells that overexpress Pgp can be modified by the presence of Pgp antagonists. In a Phase I trial of the Pgp reversal agent PSC 833, we show that the effects of this reversal agent can also be demonstra...

BACKGROUND In contrast to 201TlCl, 99mTc-sestamibi shows very slow myocardial clearance after its initial myocardial uptake. In the present study, myocardial washout of 99mTc-sestamibi was calculated in patients with non-ischemic chronic heart failure (CHF) and compared with biventricular parameters obtained from first-pass and ECG-gated myocardial perfusion SPECT data. METHODS AND RESULTS Af...

UNLABELLED This study was undertaken to determine the effects of collimators on the accuracy of preoperative sestamibi parathyroid imaging of the neck. METHODS Forty-nine patients with primary hyperparathyroidism underwent preoperative (99m)Tc-sestamibi parathyroid imaging. The protocol included early and late pinhole and parallel-hole imaging. One experienced nuclear physician, without knowl...

HYPOTHESIS The sensitivity of sestamibi scanning techniques used for preoperative localization in primary hyperparathyroidism is a function of the parameters of image acquisition and processing. DESIGN Criterion standard vs optimized technique. SETTING Tertiary referral center. PATIENTS One hundred forty-eight consecutive patients with primary hyperthyroidism were analyzed. Under the init...