Parathyroid Scan

A parathyroid scan is sometimes called a parathyroid localization scan or parathyroid scintigraphy. This scan uses radioactive pharmaceuticals that are readily taken up by cells in the parathyroid glands to obtain an image of the glands and any abnormally active areas within them.

Purpose

The parathyroid glands, embedded in the thyroid gland in the neck, but separate from the thyroid in function, control calcium metabolism in the body. The parathyroid glands produce parathyroid hormone (PTH). PTH regulates the level of calcium in the blood.

Calcium is critical to cellular metabolism, as well as being the main component of bones. If too much PTH is secreted, the bones release calcium into the bloodstream. Over time, the bones become brittle and more likely to break. A person with levels of calcium in the blood that are too high feels tired, run down, irritable, and has difficulty sleeping. Additional signs of too much calcium in the blood are nausea and vomiting, frequent urination, kidney stones and bone pain. A parathyroid scan is administered when the parathyroid appears to be overactive and a tumor is suspected.

Precautions

Parathyroid scans are not recommended for pregnant women because of the potential harm to the developing fetus. People who have had another recent nuclear medicine procedure or an intravenous contrast test may need to wait until the earlier radioactive markers have been eliminated from their system in order to obtain accurate results from the parathyroid scan.

Description

A parathyroid scan is a non-invasive procedure that uses two radiopharmaceuticals (drugs with a radioactive

The parathyroid glands, embedded in the thyroid gland in the neck but separate from the thyroid gland in function, control calcium metabolism in the body by producing parathyroid hormone, or PTH. (Custom Medical Stock Photo. Reproduced by permission.)

marker) to obtain an image of highly active areas of the parathyroid glands. The test can be done in two ways.

Immediate scan

If the test is to be performed immediately, the patient lies down on an imaging table with his head and neck extended and immobilized. The patient is injected with the first radiopharmaceutical. After waiting 20 minutes, the patient is positioned under the camera for imaging. Each image takes five minutes. It is essential that the patient remain still during imaging.

After the first image, the patient is injected with a second radiopharmaceutical, and imaging continues for another 25 minutes. Total time for the test is about one hour: injection 10 minutes, waiting period 20 minutes, and imaging 30 minutes.

Another way to do this test is as follows. After the first images are acquired, the patient returns two hours later for additional images. Time for this procedure totals about three hours: injection 10 minutes, waiting period two hours and 20 minutes, and imaging 30 minutes.

Delayed scan

In a delayed parathyroid scan, the patient is asked to swallow capsules containing the first radiopharmaceutical. The patient returns after a four hour waiting period, and the initial image is made. Then the patient is injected with the second radiopharmaceutical. Imaging continues for another 25 minutes. The total time is about four hours and 40 minutes: waiting period four hours, injection 10 minutes, and imaging 30 minutes.

Preparation

No special preparations are necessary for this test. It is not necessary to fast or maintain a special diet. The patient should wear comfortable clothing and no metal jewelry around the neck.

Aftercare

The patient should not feel any adverse effects of the test and can resume normal activities immediately.

Risks

The only risk associated with this test is to the fetus of a pregnant woman.

Normal results

Normal results will show no unusual activity in the parathyroid glands.

Abnormal results

A concentration of radioactive materials in the parathyroid gland beyond background levels suggests excessive activity and the presence of a tumor. False positive results sometimes result from the presence of multinodular goiter, neoplasm, or cysts. False positive tests are tests that interpret the results as abnormal when this is not true.