Zwas S T, Czerniak A, Boruchowsky S, Avigad I, Wolfstein I
J Nucl Med. 1987 Mar;28(3):298-307.
A new parathyroid scintigraphic localization study by a dual radioisotope technique using radioiodinated toluidine blue (RTB) for the parathyroids and 99mTc for thyroid imaging is presented. A simple RTB labeling procedure achieving 99% tagging of the 131I-TB was used. The RTB was found to be a highly specific parathyroid radiotracer, consequently enabling superimposition of the delineated thyroid gland over the RTB avid parathyroid foci without a need for subtraction of the thyroid or vascular background. Forty-six patients with primary hyperparathyroidism underwent scintigraphic study prior to cervical (41 patients) or mediastinal (5 patients) exploration and 67 pathological parathyroid glands (34 adenomas and 33 hyperplasias) were excised. On follow-up, serum calcium level returned to normal in all patients. Correlation of the scintigraphic results with the surgical findings disclosed a sensitivity of 93%, with a specificity of 80% and an overall accuracy of 87%. This new simplified and specific RTB scintigraphic method justifies its use as a routine procedure for preoperative parathyroid scintigraphic localization in primary hyperparathyroidism.
本文介绍了一种新的甲状旁腺闪烁显像定位研究，采用双放射性同位素技术，用放射性碘化甲苯胺蓝（RTB）对甲状旁腺进行显像，用99mTc对甲状腺进行显像。采用了一种简单的RTB标记程序，可使131I-TB的标记率达到99%。结果发现RTB是一种高度特异性的甲状旁腺放射性示踪剂，因此无需减去甲状腺或血管背景，即可将勾勒出的甲状腺叠加在摄取RTB的甲状旁腺病灶上。46例原发性甲状旁腺功能亢进患者在进行颈部（41例）或纵隔（5例）探查前接受了闪烁显像研究，并切除了67个病理性甲状旁腺（34个腺瘤和33个增生）。随访发现，所有患者的血清钙水平均恢复正常。闪烁显像结果与手术结果的相关性显示，敏感性为93%，特异性为80%，总准确率为87%。这种新的简化且特异的RTB闪烁显像方法证明了其作为原发性甲状旁腺功能亢进术前甲状旁腺闪烁显像定位常规程序的合理性。
