2-Methoxyisobutylisonitrile probe during parathyroid surgery: tool or gadget?
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.
Bonjer
H J
HJ
Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Bruining
H A
HA
Pols
H A
HA
de Herder
W W
WW
Proye
C A
CA
Carnaille
B M
BM
Mohammedamin
R S
RS
Steyerberg
E W
EW
Breeman
W A
WA
Krenning
E P
EP
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
D017256:Technetium Tc 99m Sestamibi