Female, 62 year old, with recurrent primary hyperthyroidism. Her exams showed increased PTH levels. Parathyroid spect with ct fusion using reference markers (white arrows) demonstrated a 1.5x2 cm nodule concentrating moderately 99mTc-sestamibi. In the fusion the lesion is located in the right side prevertebrally at the level of T1-T2, behind and lateral to the trachea and esophagus (yellow arrows).
 

References:

1   Detlef Moka, Eberhard Voth, et al. Technetium 99m-MIBI-SPECT: A highly sensitive diagnostic tool for localization of parathyroid adenomas. Surgery 2000;128:29-35.
2   Mordechai Lorberboym, Irit Minski, et al. Incremental Diagnostic Value of Preoperative 99mTc-MIBI SPECT in Patients with a Parathyroid Adenoma. J Nucl Med 2003; 44:904–908.

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