Pharmacological intervention with calcitonin in scintiscan using 99Tc-Sestamibi in two phases to the location of adenoma and / or hyperplasia of parathyroid

Introduction: There is a need to improve the methods for the diagnosis of parathyroid disease allowing to make the most appropriate therapeutic decision. With this purpose, we performed a retrospective study in order to evaluate the diagnostic accuracy of 99mTc-Sestamibi scintigraphy after pharmacologic intervention with calcitonin in patients with primary hyperparathyroidism. Methods: Patients with diagnosis of primary hyperparathyroidism were included, who were consecutively evaluated with parathyroid scintigraphy using the standard double-phase 99mTc-Sestamibi protocol and a study with 99mTc-Sestamibi-calcitonin, having received a follow-up of at least 6 months after the nuclear study. Sensitivity (SENS), specificity (SPE) and accuracy (ACC) were calculated for each protocol, among other statistical parameters. Results: Forty-two patients were submitted for basal and post-calcitonin scintigraphy, of which 35 had a complete follow-up. a) Basal study: SENS 65,6%, SPE 100%, ACC 68,5%. After classification according to pathology: for adenoma, SENS 53,8%, SPE 54,5%; for hyperplasia, SENS 25%, SPE 90%. b) Post-calcitonin study: SENS 92,3%, SPE 43,5%, ACC 94,3%. For adenoma, SENS 92,3%, SPE 45,5%; for hyperplasia, SENS 25%, SPE 77,4%. Conclusions: Our results using calcitonin protocol demonstrate an increase in global sensitivity, helping to better classify patients with parathyroid disease by improving diagnostic accuracy