99mTc-tetrofosmin or 99mTc-sestamibi for double-phase parathyroid scintigraphy?

Several years ago technetium-99m tetrofosmin was reported to localise parathyroid adenomas. The aim of this study was to compare the sensitivity of this radiopharmaceutical with that of Tc-99m-sestamibi using a double-phase parathyroid scintigraphy protocol. Scans of 12 patients were evaluated visually and lesion to thyroid ratios were calculated. Nine of the patients were subsequently operated on; a total of eight parathyroid adenomas or hyperplastic glands were histologically confirmed in seven of the patients, while in one patient a parathyroid carcinoma was histologically proven. All of these patients had positive Tc-99m-sestamibi scintigrams, whereas only two Tc-99m-tetrofosmin scimigrams were positive. With Tc-99m-sestamibi there was a significant increase in the lesion to thyroid ratio from 10 min to 90 min and 150 min p.i. which was not seen on scintigraphy with Tc-99m-tetrofosmin. This makes Tc-99m-tetrofosmin less suitable for double-phase parathyroid scintigraphy.