What’s a Sestamibi scan?

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A sestamibi scan is a nuclear medicine procedure performed for patients with parathyroid gland disorders. It is not a diagnostic study or confirmatory test for the presence of hyperparathyroidism. It is rather done to distinguish or locate the affected gland in a patient already diagnosed with the disease.
The parathyroid glands are four small glands located in the neck and behind the thyroid gland. These glands regulate the level of calcium in the blood for proper muscle and nerve function. The parathyroid glands normally control the amount of calcium circulating in the blood, and when the calcium level drops, the glands release parathyroid hormones (PTH), which stimulate the bones to produce more calcium.

Hyperparathyroidism is the main disease affecting these glands. It causes excessive activity of the glands, often resulting in an increase in the level of calcium in the blood. This is mainly due to the presence of a tumor or cancer in one or more glands. Symptoms usually present as fatigue, osteoporosis or weakening of bones, bone pain, irritability, and depression. Affected individuals may also manifest with decreased sex drive, recurring headaches, high blood pressure, and kidney stones.

Endocrinologists are doctors who treat patients with hormonal imbalances. They often diagnose patients with hyperparathyroidism by doing a thorough physical exam and with the help of blood tests and other diagnostic procedures. Treatment may include the use of medications and sometimes surgery to remove the affected gland. When removal of the gland is necessary, a preoperative sestamibi scan is usually done to determine the location of the diseased parathyroid gland.

It typically takes less than three hours to perform the sestamibi scanning procedure. Twenty minutes before the procedure, a patient is sometimes given lemon juice to reduce saliva production. During the procedure, a radioactive dye called technecium99 (Tc-99) is injected into the patient’s vein. An overactive parathyroid gland often absorbs this dye and this can be seen in the pictures taken during the procedure. Surgeons, the doctors who perform the operations, can then set a schedule for removing the affected gland using a minimally invasive procedure.

The sestamibi scan is a relatively safe and accurate procedure. Unlike other iodine-based procedures, the sestamibi Tc-99 scan produces no adverse reactions or allergies. After the procedure, the patient does not need to be isolated from other people because the radioactive dye used was very mild.

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