66 Normal Parathyroid Bed

Clinical Presentation

A 34-year-old man presents with a long history of hyperparathyroidism. A sestamibi study is obtained for parathyroid localization.

Fig. 66.1 Top row: 20-minute images; bottom row: 2-hour images. The middle column shows marker views.

Technique

• Approximately 20 mCi of ^99mTc-sestamibi injected intravenously

• High-resolution collimator

• Anterior view of the neck and chest done at 20 minutes and 2 hours after injection

• Pinhole view of the thyroid bed done at 20 minutes and 2 hours after injection

Image Interpretation

Normal uptake is seen in the region of the thyroid bed (Fig. 66.1). A vague blush in the region of the mediastinum is also noted but not seen clearly enough to be diagnostic. Retention of nuclide in this area is unchanged on the delayed images, which is consistent with delayed washout.