Intraoperative 99mTc-MIBI-guided detection of ectopic glands in secondary hyperparathyroidism.
99mTc-MIBI-guided detection of abnormal parathyroid glands in primary hyperparathyroidism (1-HPT) has become a popular and effective technique, but its efficacy for detecting the ectopic glands of secondary hyperparathyroidism (2-HPT) is still controversial. Of the 2-HPT cases from 2000 to 2004, 14 ectopic parathyroid glands in 11 patients were resected using intraoperative 99mTc-MIBI scintigraphy. We evaluated and compared the results of radioguided surgery with the preoperative findings from ultrasonography (US), computed tomography (CT), and scintigraphy. The overall results for intraoperative 99mTc-MIBI-guided detection of ectopic parathyroid glands were sensitivity of 100% (14/14) and accuracy of 84.2% (16/19) compared with 42.9% (6/14) and 31.6% (6/19), respectively, for preoperative US and 50.0% (6/12) and 42.9% (6/14), respectively, for preoperative 99mTc-MIBI scintigraphy. Using intraoperative 99mTc-MIBI-guided surgery in cases of 2-HPT will ensure all ectopic parathyroid glands are detected, making the surgery easier to perform and the outcome more successful.
Takeyama
Hiroshi
H
Department of Surgery, The Jikei University School of Medicine, Nishi-sinbashi, Tokyo, Japan. takeyama@jikei.ac.jp
Shioya
Hisashi
H
Ogi
Shigeyuki
S
Yokoyama
Keitaro
K
Yamamoto
Hiroyasu
H
Odaka
Makoto
M
Sato
Shuji
S
Kinoshita
Satoki
S
Uchida
Ken
K
Morikawa
Toshiaki
T
D000328:Adult; D000368:Aged; D002828:Choristoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000601:surgery; D006965:Hyperplasia; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D025321:Surgery, Computer-Assisted; D017256:Technetium Tc 99m Sestamibi; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi