title: The effectiveness of low-dose versus high-dose 99mTc MIBI protocols for radioguided surgery in patients with primary hyperparathyroidism.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy of low-dose and high-dose (99m)Tc methoxy isobutyl isonitrile (MIBI) protocols in intraoperative localization of parathyroid adenomas by means of a gamma probe in patients with primary hyperparathyroidism (PHPT).
  
  
  METHODS
  The study included 62 patients with PHPT who were divided into two groups. Group 1 consisted of 32 patients who were injected with a low dose (1 mCi) of (99m)Tc MIBI in the surgical suite 10 min before incision. Group 2 included 30 patients who were intravenously administered a high dose (15 mCi) of (99m)Tc MIBI 2 h before surgery. With the aid of a gamma probe, intraoperative localization of parathyroid adenomas was performed in both groups of patients who underwent minimally invasive parathyroidectomy. All lesions thought to be parathyroid adenomas were excised and subsequently evaluated histopathologically.
  
  
  RESULTS
  All parathyroid adenomas in both groups were localized and excised by means of an intraoperative gamma probe. The sensitivity, specificity, and accuracy of low-dose and high-dose (99m)Tc MIBI protocols in the intraoperative localization of adenomas in patients with PHPT were 100%.
  
  
  CONCLUSIONS
  In the light of these findings, we conclude that low-dose (99m)Tc MIBI may be preferred to intraoperative identification of parathyroid adenomas by means of a gamma probe in PHPT patients because it appears to be as effective as high-dose (99m)Tc MIBI. Moreover, the low-dose protocol does not have the disadvantages of high-dose protocol.
authors: Departments of aNuclear Medicine bSurgery, Baskent University Medical Faculty, Ankara, Turkey.
authors: Esra A
authors: EA
authors: Gencoglu
authors: Murat
authors: M
authors: Aras
authors: Gokhan
authors: G
authors: Moray
authors: Ayse
authors: A
authors: Aktas
mesh_terms: D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods*; D011184:Postoperative Period; D011829:Radiation Dosage; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors
chemical_list: D017256:Technetium Tc 99m Sestamibi; D002118:Calcium