The efficacy of low and high dose (99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism.
OBJECTIVE
The aim of this study was to compare the efficacy of low- and high-dose (99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands via gamma probe in secondary hyperparathyroidism.


METHODS
This retrospective study was conducted using a prospective database of 59 patients who had undergone radioguided subtotal parathyroidectomy between 2004-2012. The patients were studied in 2 groups. Group 1 (n=31) received 37 MBq (99m)Tc-MIBI intravenously in the surgical room approximately 10 min before the beginning of the intervention and surgery was performed under gamma probe guidance. Group 2 (n=28) received 555 MBq (99m)Tc- MIBI intravenously 2h before surgery, which was also performed under gamma probe guidance. Intraoperative gamma probe findings, laboratory findings, and histopathological findings were evaluated together.


RESULTS
Using acceptance of the histopathological findings as gold standard, sensitivity and specificity of intraoperative gamma probe for identifying hyperplastic parathyroid glands was 98% and 100%, respectively, in both groups.


CONCLUSIONS
In the light of these findings, it is concluded that the low-dose (99m)Tc-MIBI protocol might be preferable for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism patients because it was observed to be as effective as the high-dose (99m)Tc-MIBI protocol. Furthermore, the low-dose protocol does not have the disadvantages that are associated with the high-dose protocol.
Department of Nuclear Medicine Baskent University Medical Faculty, Ankara, Turkey. Electronic address: arzugencoglu@yahoo.com.
Esra Arzu
EA
Gencoglu
Department of Nuclear Medicine Baskent University Medical Faculty, Ankara, Turkey.
Ayse
A
Aktas
D000328:Adult; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications* / Q000601:surgery*; D006965:Hyperplasia / Q000150:complications / Q000000981:diagnostic imaging; D007432:Intraoperative Period; D008297:Male; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000473:pathology*; D016105:Parathyroidectomy; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi / Q000008:administration & dosage*
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
(99m)Tc MIBI; (99m)Tc-MIBI; Cirugía radioguiada; Gamma probe; Hiperparatiroidismo secundario; Radio-guided surgery; Secondary hyperparathyroidism; Sonda gamma