Document Detail


Intraoperative nuclear guidance in benign hyperparathyroidism and parathyroid cancer.
MedLine Citation:
PMID:  9143460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The success of parathyroid surgery is determined by the identification and removal of all hyperactive parathyroid tissue. Ectopic location of parathyroid tumours and fibrosis due to previous operations can cause failure of parathyroidectomy. Parathyroid tumours accumulate and retain 2-methoxyisobutylisonitrile (MIBI) labelled with technetium-99m. This study assesses the value of intra-operative localization of parathyroid tumours using a hand-held gamma detector in patients with hyperparathyroidism and parathyroid cancer. Twenty patients undergoing their first operations for hyperparathyroidism, 15 patients undergoing reoperations for either persistent or recurrent hyperparathyroidism and two patients with parathyroid cancer were studied. Radioactivity in the neck and the mediastinum was recorded by a gamma detector after administration of 370 MBq 99m Tc-MIBI. Surgical findings and postoperative serum levels of calcium were documented. The sensitivity of the gamma detector in identifying parathyroid tumours was 90.5% in first parathyroidectomies, 88.9% in reoperations for either persistent or recurrent hyperparathyroidism and 100% in parathyroid cancer. One false-positive result was due to a thyroid nodule. Hypercalcaemia ceased in all but one patient postoperatively. It is concluded that employment of the gamma detector is to be advocated in first parathyroidectomies when a parathyroid tumour cannot be discovered, in reoperations for either persistent or recurrent hyperparathyroidism and in surgery for parathyroid cancer.
Authors:
H J Bonjer; H A Bruining; H A Pols; W W de Herder; C H van Eijck; W A Breeman; E P Krenning
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of nuclear medicine     Volume:  24     ISSN:  0340-6997     ISO Abbreviation:  Eur J Nucl Med     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-06-03     Completed Date:  1997-06-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7606882     Medline TA:  Eur J Nucl Med     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  246-51     Citation Subset:  IM    
Affiliation:
Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Evaluation Studies as Topic
Female
Humans
Hyperparathyroidism / radionuclide imaging*,  surgery*
Intraoperative Care / instrumentation,  methods
Male
Middle Aged
Parathyroid Neoplasms / radionuclide imaging*,  surgery*
Parathyroidectomy / methods
Reoperation
Scintillation Counting
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use*
Chemical
Reg. No./Substance:
109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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