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FIGURE 4. Parathyroid scintigraphy according to dual-tracer protocol (99mTc-pertechnetate and 99mTc-sestamibi), with administration of KClO4- at start of 99mTc-pertechnetate imaging. (Top left) Virtually normal thyroid gland. (Top center) Five-minute scan recorded within 35 min of 99mTc-sestamibi injection shows summation scan suggesting presence of adenoma of upper left parathyroid gland, better outlined when subtracting 99mTc-pertechnetate scan from summation scan (top right). Minimally invasive radioguided surgery confirmed presence of parathyroid adenoma. (Bottom left) Virtually normal thyroid gland. (Bottom center) Five-minute scan recorded within 35 min of 99mTc-sestamibi injection shows summation scan suggesting presence of adenoma of lower left parathyroid gland, better outlined when subtracting 99mTc-pertechnetate scan from summation scan (bottom right). Minimally invasive radioguided surgery confirmed presence of parathyroid adenoma.
