title: Use of a handheld, semiconductor (cadmium zinc telluride)-based gamma camera in navigation surgery for primary hyperparathyroidism.
abstract: The recent development of gamma-ray probes makes it possible to perform radioguided surgery for primary hyperparathyroidism (PHPT). There have only been a few reports, however, regarding the use of a handheld gamma camera to detect parathyroid adenoma intraoperatively. The aim of this preliminary study was to assess the efficiency of a semiconductor gamma camera (eZ-SCOPE AN) in navigation surgery for PHPT. The eZ-SCOPE is designed to be used as a handheld, regional diagnostic imaging device. Eleven consecutive patients with documented primary hyperparathyroidism underwent surgery using this compact camera. Scintigraphy images of the neck by eZ-SCOPE were acquired: 1) before skin incision; 2) after adenoma location; 3) after adenoma excision; and 4) ex vivo imaging of the specimen. In scan-positive cases by preoperative Tc-MIBI, the eZ-SCOPE revealed parathyroid adenoma in all cases (100%), whereas ultrasound and CT showed a single adenoma in 63.6 and 72.7 per cent of cases, respectively. Navigation surgery for PHPT using the eZ-SCOPE permitted intraoperative identification and removal of parathyroid adenoma in all cases. Scintigraphy images of the neck by eZ-SCOPE also revealed a single adenoma even before skin incision. Our results suggest that Tc-MIBI scintigraphy with the eZ-SCOPE is useful for navigation surgery for PHPT. The eZ-SCOPE is useful for skin marking and could be easily applied for minimally invasive radioguided parathyroidectomy in scan-positive cases.
authors.affiliation: Division of Clinical Radiology, Graduate School of Medicine, Gunma University, Gunma, Japan. nkulvatunyou@surgery.arizona.edu
authors.forename: Takaaki
authors.initials: T
authors.lastname: Fujii
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Reina
authors.initials: R
authors.lastname: Yajima
authors.forename: Soichi
authors.initials: S
authors.lastname: Tsutsumi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Uchida
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.forename: Noboru
authors.initials: N
authors.lastname: Oriuch
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D004867:Equipment Design; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009333:Neck / Q000000981:diagnostic imaging; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011877:Radionuclide Imaging; D012666:Semiconductors; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*