Usefulness of intraoperative 99m Tc-MIBI-guided detection for recurrent sites in secondary hyperparathyroidism: a case-controlled study.
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.
Takeyama
Hiroshi
H
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
Tabei
Isao
I
Ogi
Shigeyuki
S
Yokoyama
Keitaro
K
Yamamoto
Hiroyasu
H
Okido
Ichiro
I
Kinoshita
Satoki
S
Kurihara
Hideaki
H
Yoshida
Kazuhiko
K
Uchida
Ken
K
Morikawa
Toshiaki
T
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
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi