| Intraoperative nuclear guidance in benign hyperparathyroidism and parathyroid cancer. | |
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MedLine Citation:
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PMID: 9143460 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: European journal of nuclear medicine Volume: 24 ISSN: 0340-6997 ISO Abbreviation: Eur J Nucl Med Publication Date: 1997 Mar |
Date Detail:
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Created Date: 1997-06-03 Completed Date: 1997-06-03 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7606882 Medline TA: Eur J Nucl Med Country: GERMANY |
Other Details:
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Languages: eng Pagination: 246-51 Citation Subset: IM |
Affiliation:
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Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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109581-73-9/Technetium Tc 99m Sestamibi |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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