ABSTRACT
A 64-year-old woman with a history of I-131 ablation for Graves hyperthyroidism and bilateral parathyroid exploration with resection of a left inferior parathyroid adenoma presented 2 years after surgery with marked fatigue, irritability, and joint pain. Laboratory testing revealed an elevated calcium and parathyroid hormone levels suspicious for hyperparathyroidism. The ultrasound indicated no evidence of a parathyroid adenoma. Tc-99m-MIBI SPECT demonstrated a focus of uptake posteroinferior to the right submandibular gland, suspicious for a parathyroid adenoma. Repeat ultrasound and CT confirmed the presence of a para-hyoid adenoma inferior to the right submandibular gland.
Subject(s)
Choristoma/diagnostic imaging , Choristoma/pathology , Hyoid Bone/diagnostic imaging , Hyoid Bone/pathology , Parathyroid Neoplasms/diagnostic imaging , Technetium Tc 99m Sestamibi , Tomography, Emission-Computed, Single-Photon , Female , Humans , Middle Aged , Tomography, X-Ray Computed , UltrasonographySubject(s)
Lung Neoplasms/complications , Lung Neoplasms/diagnostic imaging , Osteoarthropathy, Secondary Hypertrophic/diagnosis , Osteoarthropathy, Secondary Hypertrophic/etiology , Technetium Tc 99m Medronate , Aged , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Diagnosis, Differential , Female , Humans , Radionuclide Imaging , RadiopharmaceuticalsABSTRACT
BACKGROUND: The potential applications of molecular imaging in the clinical arena are diverse and expanding rapidly. One such area of application is transplantation. Currently, biopsy is the gold standard for monitoring allograft well-being after transplantation of organs or tissues. However, biopsies are invasive, associated with morbidity if performed on a routine basis and can potentially miss focal rejection. AIM: It is notable that none of the existing studies in the literature have examined the possible role of molecular imaging in transplantation-related indications. In this direction, this paper aims to discuss imaging strategies that could be of pertinence in monitoring immune events and improving long-term outcomes after solid organ or tissue transplantation. METHODS: This paper discusses the currently available direct/surrogate imaging techniques/agents that can be used to detect chemokine receptors/ligands, leucocyte endothelial events and ischaemia-reperfusion injury in transplantation. CONCLUSION: Molecular imaging methods can non-invasively detect, quantify and monitor immune phenomena, such as rejection or graft-versus-host disease, after transplantation. Molecular imaging could help in targeted biopsy and could improve graft survival by allowing for early intervention with tailored immunosuppressive regimens. Given the unprecedented progress in the field, the potential benefits of molecular imaging to the speciality of organ and tissue transplantation cannot be underestimated.
