False Positive Brown Adipose Tissue Uptake on Parathyroid 99mTc-Sestamibi Scan

Authors

  • Chetan Thapa Department of Radiology, Gold Coast University Hospital, Southport, Australia
  • Tahleesa Cuda 2Department of Nuclear Medicine and Specialist PET Services Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia 3Molecular Imaging and Therapy, Austin Health, Melbourne, Australia 4Faculty of Medicine, University of Queensland, Australia
  • Evyn Arnfield Department of Nuclear Medicine and Specialist PET Services Queensland, Royal Brisbane and Women’s Hospital, Brisbane, Australia/Faculty of Medicine, University of Queensland, Australia

DOI:

https://doi.org/10.3941/jrcr.5780

Abstract

An 18-year-old female was found to have hyperparathyroidism and severe chronic renal failure of unclear cause. Dual-isotope parathyroid imaging was performed to exclude a parathyroid adenoma. Pinhole scintigraphy following intravenous administration of 99mTc-pertechnetate showed homogenous activity throughout the orthotopic thyroid gland. Early and delayed pinhole and planar scintigraphy following 99mTc-sestamibi administration showed discordant activity in the bilateral neck and supraclavicular regions, confirmed as brown adipose tissue on SPECT-CT. This case demonstrates false positive 99mTc-sestamibi uptake within brown adipose tissue in the neck and illustrates the value of SPECT-CT in differentiating brown adipose tissue from parathyroid activity.

Early and delayed pinhole and planar scintigraphy demonstrating homogenous 99mTc-pertechnetate activity throughout the thyroid and discordant 99mTc-sestamibi activity within the bilateral supraclavicular regions; (b) representative early axial and coronal SPECT-CT imaging with arrows indicating sites of intense 99mTc-sestamibi activity within supraclavicular brown adipose tissue (BAT).

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Published

2025-08-03

Issue

Vol. 19 No. 8 (2025)

Section

Interesting Image

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