title: 2-Methoxyisobutylisonitrile probe during parathyroid surgery: tool or gadget?
abstract: The success of parathyroid surgery is determined by the identification and removal of all parathyroid tumors. Parathyroid tumors accumulate and retain 2-methoxyisobutylisonitrile (MIBI) labeled with technetium-99m. Intravenous injection of this radiopharmacon prior to parathyroid surgery allows identification of parathyroid tumors with a hand-held gamma detector. To assess the value of this technique, a case-control study was performed with 62 patient having nuclear-guided parathyroidectomy and 60 patients having conventional parathyroid explorations. The sensitivity rates of the MIBI probe in single and multiple gland disease were 84.6% and 63.0%, respectively. Rates of success, temporary and permanent hypoparathyroidism, and injury of the recurrent laryngeal nerve were similar in patients who underwent probe-guided surgery and those who had conventional surgery. In conclusion, although the MIBI probe appears to be a valuable tool in parathyroid surgery, its use has not improved the outcome of such surgery at our institution.
authors.affiliation: Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
authors.forename: H A
authors.initials: HA
authors.lastname: Bruining
authors.forename: H A
authors.initials: HA
authors.lastname: Pols
authors.forename: W W
authors.initials: WW
authors.lastname: de Herder
authors.forename: C A
authors.initials: CA
authors.lastname: Proye
authors.forename: B M
authors.initials: BM
authors.lastname: Carnaille
authors.forename: R S
authors.initials: RS
authors.lastname: Mohammedamin
authors.forename: E W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: W A
authors.initials: WA
authors.lastname: Breeman
authors.forename: E P
authors.initials: EP
authors.lastname: Krenning
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi