Gamma probe identification of normal parathyroid glands during central neck surgery can facilitate parathyroid preservation.
BACKGROUND
We evaluated gamma probe identification (GPI) of sestamibi-labeled normal parathyroid glands during central neck surgery.


METHODS
GPI was judged to be helpful if it resulted in the identification of parathyroid glands not identified by direct inspection.


RESULTS
GPI was performed in 54 patients and was helpful in 20, including 9 patients in whom GPI identified intact parathyroid glands in vivo and 11 patients in whom GPI identified incidentally excised parathyroid glands ex vivo in the central neck dissection (CND) specimen. GPI was more commonly helpful in patients who underwent reoperation (9/16, 56%) compared with primary surgery (11/38, 29%; P = .04) and was more commonly helpful in patients who underwent CND (17/28, 61%) compared with thyroidectomy without CND (2/26, 8%; P < .0001). In 11 patients, normal parathyroid glands were salvaged by GPI from the ex vivo CND specimens and autografted.


CONCLUSIONS
GPI is a relatively simple and effective technique that may help maximize parathyroid preservation.
Grubbs
Elizabeth G
EG
Section of Endocrine Tumor Surgery, Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1400 Holcombe Boulevard, Box 301402, Houston, TX 77030-4009, USA.
Mittendorf
Elizabeth A
EA
Perrier
Nancy D
ND
Lee
Jeffrey E
JE
D005500:Follow-Up Studies; D015902:Gamma Cameras; D006801:Humans; D007011:Hypoparathyroidism / Q000517:prevention & control*; D037981:Neck Dissection / Q000009:adverse effects*; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012307:Risk Factors; D017256:Technetium Tc 99m Sestamibi; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi