title: Usefulness of intraoperative 99m Tc-MIBI-guided detection for recurrent sites in secondary hyperparathyroidism: a case-controlled study.
abstract: OBJECTIVE
  (99m)Tc-Methoxyisobutylisonitrile ((99m)Tc-MIBI)-guided surgery for the detection of abnormal parathyroid glands in primary hyperparathyroidism (1-HPT) has gained popularity as an effective technique. However, in secondary hyperparathyroidism (2-HPT), the efficacy of this method remains controversial, especially for the recurrence sites of 2-HPT.
  
  
  METHODS
  (99m)Tc-MIBI-guided surgery was performed for 28 recurrent sites of transplanted parathyroid tissue in 4 patients, and the detection rates of this method were compared with the results of preoperative ultrasound (US) examination and computed tomography (CT) scanning.
  
  
  RESULTS
  The results of (99m)Tc-MIBI-guided surgery for regions of recurrence were a sensitivity of 100% (28/28) and an accuracy of 100% (29/29), compared with preoperative US and CT which had a sensitivity of 92.9% (26/28) and 0% (0/28), and an accuracy of 89.7% (26/29) and 0% (0/28), respectively.
  
  
  CONCLUSIONS
  Intraoperative (99m)Tc-MIBI-guided surgery can identify recurrent parathyroid tissues of 2-HPT more precisely than preoperative US examination or CT scanning, and makes the surgery easier to perform.
authors.affiliation: Department of Surgery, Jikei University, School of Medicine, Daisan-Hospital, 4-11-1, Izumi-Honcho, Komae city, Tokyo 201-8601, Japan. takeyama@jikei.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeyama
authors.forename: Isao
authors.initials: I
authors.lastname: Tabei
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ogi
authors.forename: Keitaro
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Okido
authors.forename: Satoki
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kurihara
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshida
authors.forename: Ken
authors.initials: K
authors.lastname: Uchida
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morikawa
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000473:pathology / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology / Q000637:transplantation; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods*; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D012008:Recurrence; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi