Nuclear medicine: parathyroid imaging: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Nuclear medicine: parathyroid imaging

Sample item

Which radiopharmaceutical is used to localise a parathyroid adenoma before surgery in primary hyperparathyroidism?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Tc-99m sestamibi

Sestamibi is taken up by thyroid and parathyroid tissue, and washes out of the thyroid faster than from an adenoma, so delayed images show a persistent focus. SPECT/CT improves localisation. MDP images bone and DTPA images the kidneys.

Option by option

  • A. Tc-99m MDP

    MDP is a bone agent.

  • B. I-131 MIBG

    MIBG images neuroendocrine tumours such as pheochromocytoma.

  • C. Tc-99m DTPA

    DTPA images the kidney and brain.

  • D. Tc-99m sestamibi (correct)

    Correct. Sestamibi localises hyperfunctioning parathyroid tissue.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Tc-99m sestamibi. Sestamibi is taken up by thyroid and parathyroid tissue, and washes out of the thyroid faster than from an adenoma, so delayed images show a persistent focus.

Why is "Tc-99m MDP" not the answer?

MDP is a bone agent.

Why is "I-131 MIBG" not the answer?

MIBG images neuroendocrine tumours such as pheochromocytoma.

Why is "Tc-99m DTPA" not the answer?

DTPA images the kidney and brain.

What concept does this question test?

It tests Nuclear medicine: parathyroid imaging in Radiology. SPECT/CT improves localisation. MDP images bone and DTPA images the kidneys.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nuclear medicine: parathyroid imaging?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.