Effect of calcium channel blockers on the sensitivity of preoperative 99mTc-MIBI SPECT for hyperparathyroidism

Kent Friedman, Helina Somervell, Pavni Patel, Genevieve B. Melton, Elizabeth Garrett-Mayer, Alan P B Dackiw, A. Cahid Civelek, Martha A. Zeiger

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Technetium 99m (99mTc)-methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) is frequently used in the evaluation of patients with hyperparathyroidism. Calcium channel blockers (CACBs) may affect 99mTc-MIBI uptake by parathyroid cells. This study examines the effect of CACB therapy on the sensitivity of 99mTc-MIBI SPECT localization for hyperparathyroidism. Two hundred fifty-three operated patients with hyperparathyroidism were retrospectively reviewed. The potential effect of CACB therapy on 99mTc-MIBI scan sensitivity was examined by using logistic regression analysis. Possible confounding factors were considered. Among 235 patients, those with multiple endocrine neoplasia, type I (MEN-I), MEN-IIA, 4-gland hyperplasia, secondary hyperparathyroidism, and tertiary hyperparathyroidism exhibited no difference associated with CACB use. Of the remaining 198 patients with primary hyperparathyroidism, 7/30 (23%) with negative 99mTc-MIBI SPECT scans compared to 24/168 (14%) with positive scans used CACBs. After correcting for age, gender and gland weight, the odds ratio (OR) for a negative study in patients taking CACBs was 2.88 (95% CI, 1.03-8.10; P=. 045). Atherosclerosis, hypertension, diabetes mellitus, preoperative calcium and parathyroid hormone levels, and thyroid hormone use were not confounding factors. CACB therapy reduces the sensitivity of 99mTc-MIBI parathyroid SPECT in patients with primary hyperparathyroidism. Further studies are required to determine the potential reversibility of this effect with termination of CACB therapy.

Original languageEnglish (US)
Pages (from-to)1199-1204
Number of pages6
JournalSurgery
Volume136
Issue number6
DOIs
StatePublished - Dec 1 2004

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Effect of calcium channel blockers on the sensitivity of preoperative <sup>99m</sup>Tc-MIBI SPECT for hyperparathyroidism'. Together they form a unique fingerprint.

  • Cite this

    Friedman, K., Somervell, H., Patel, P., Melton, G. B., Garrett-Mayer, E., Dackiw, A. P. B., Civelek, A. C., & Zeiger, M. A. (2004). Effect of calcium channel blockers on the sensitivity of preoperative 99mTc-MIBI SPECT for hyperparathyroidism. Surgery, 136(6), 1199-1204. https://doi.org/10.1016/j.surg.2004.06.047