Assessment of the integrated role of myocardium perfusion gated SPECT study in patient with parathyroid adenoma by 99mTc-sestamibi

Introduction: The purpose of this study is to assess the integrated role of scintigraphy by Tc99m MIBI in diagnosis of parathyroid adenoma and its impacts on the myocardium, and to evaluate whether myocardium perfusion gated SPECT study could be a complementary routine workup for patient with positive parathyroid adenoma on Tc99m MIBI parathyroid scan. Methods: Rest myocardium perfusion gated SPECT study was performed on the same day of parathyroid scintigraphy, the stress study were completed on the next day for complete assessment of the myocardium perfusion and LV functions. Results: Population included 30 patients; 56% were positive for parathyroid adenoma and compared to 44% negative for parathyroid adenoma, the latter was considered as control group, the gated SPECT EF was normal in 62.5% and abnormal 37.5%. Myocardial perfusion was abnormal in 43.75%, the overall hemodynamic disorder  including EF abnormalities as well as the perfusion defects in the study group were 62.5% compared to  27.5% in the controlled group with statically significant relationship (P value=0.03). Conclusion: The risk of premature cardiovascular death in p HPT is a serious problem and the present study indicates that scintigraphically detected  parathyroid adenoma has an impact on the overall hemodynamic of the myocardium and the complementary role of rest/ stress two days protocol  Tc99m MIBI myocardium perfusion gated SPECT study may be  promising , but its usage as routine workup specially in patient with positive parathyroid adenoma and have high risk warranted further evaluation and reassessment.