title: [Initial experience in intraoperative radiolocalization of the parathyroid adenoma with freehand SPECT and comparative assessment with portable gamma-camera].
abstract: Initial experience is presented by using freehand SPECT in the intraoperative radiolocalization of a parathyroid adenoma in 2 patients, one which was mediastinal. There is only one previous publication including 3 patients with parathyroid adenomas in usual parathyroid localizations. We also report for the first time a comparative assessment of results with portable gammacamera during the same surgery. In the operating room, we obtained images with portable gamma-camera and 3 D reconstruction with freehand SPECT from 15 min after iv injection of 5 mCi of (99m)Tc-MIBI. Both devices enabled the 2 adenomas to be detected intraoperatively, as well as checking activity of the excised gland and absence of significant uptake in surgical bed, with confirmation by intraoperative pre-postsurgical PTH levels, pathology and clinical follow-up for 10 months. Both devices accurately located the parathyroid adenomas intraoperatively, as well as confirmation of their extirpation, but freehand SPECT provided additional information of adenoma depth (mm) from the skin border, very useful for minimally invasive radio-guided surgery.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario, Valencia. España. Electronic address: casans_ire@gva.es.
authors.forename: I
authors.initials: I
authors.lastname: Casáns-Tormo
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario, Valencia. España.
authors.forename: S
authors.initials: S
authors.lastname: Prado-Wohlwend
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínico Universitario, Valencia. España.
authors.forename: R
authors.initials: R
authors.lastname: Díaz-Expósito
authors.affiliation: Servicio de Cirugía, Hospital Clínico Universitario, Valencia, España.
authors.forename: N
authors.initials: N
authors.lastname: Cassinello-Fernández
authors.affiliation: Servicio de Cirugía, Hospital Clínico Universitario, Valencia, España.
authors.forename: J
authors.initials: J
authors.lastname: Ortega-Serrano
mesh_terms: D000236:Adenoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D000368:Aged; D002828:Choristoma / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D021621:Imaging, Three-Dimensional; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008479:Mediastinal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D016105:Parathyroidectomy; D015641:Radiography, Interventional / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals; D025321:Surgery, Computer-Assisted; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
keywords: Adenoma paratiroideo; Freehand SPECT; Gammacámara portátil; Intraoperative radio-guided detection; Parathyroid adenoma; Paratiroidectomía radioguiada; Portable gamma-camera; Radio-guided parathyroidectomy; Radiolocalización intraoperatoria