title: [Use of a gamma probe for intraoperative localization of parathyroid adenomas with Tc-99m-tetrofosmin and Tc-99m-sestamibi].
abstract: Especially ectopic adenomas may be problematic in intraoperative localization despite preoperative imaging resulting in a longer operating time and more extensive surgical preparation. The aim of our study was to evaluate the possibility of intraoperative scintimetric detection of parathyroid adenomas with cationic, Tc-99m labelled tracers for its usefulness in ectopic adenomas. 12 women with biochemically confirmed hyperparathyroidism were included in our study. After injection of 370 MBq Tc-99m Tetrofosmin respectively Sestamibi, preoperative scintigraphy (double phase study and SPECT) was performed and T/NT ratios were evaluated for early, delayed and SPECT images. Surgery was performed using a hand-held gamma probe after preoperative injection of 555-925 MBq Tc-99m Tetrofosmin or Sestamibi. Count rates (cts/10 sec) were measured and used for calculating in situ- and ex situ-T/NT ratios. In 9 out of 12 patients, adenoma could be detected on static images. Three cases could only be detected with SPECT. 11 of 12 parathyroid adenomas could be confirmed intraoperatively. Intraoperative localization of parathyroid adenoma with Tc-99m-labelled cationic complexes and a gamma probe is possible and may be useful in case of ectopic adenoma by influencing surgical approach and operating time.
authors.affiliation: Abteilung für Nuklearmedizin und Spezielle Endokrinologie, Landeskrankenhauses Klagenfurt, Osterreich.
authors.forename: H J
authors.initials: HJ
authors.lastname: Gallowitsch
authors.forename: J
authors.initials: J
authors.lastname: Fellinger
authors.forename: E
authors.initials: E
authors.lastname: Kresnik
authors.forename: P
authors.initials: P
authors.lastname: Mikosch
authors.forename: W
authors.initials: W
authors.lastname: Pipam
authors.forename: O F
authors.initials: OF
authors.lastname: Unterweger
authors.forename: P
authors.initials: P
authors.lastname: Lind
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; C078700:technetium tc-99m tetrofosmin; D017256:Technetium Tc 99m Sestamibi