title: The intraoperative use of the mini-gamma camera (MGC) in the surgical treatment of primary hyperparathyroidism: Technical reports and immediate results from the initial experience.
abstract: BACKGROUND
  The treatment of primary hyperparathyroidism consists almost exclusively in the parathyroidectomy. The preoperative imaging (ultrasonography, 99mTc sestamibi scan) can allow to localize the pathologic gland and perform minimally-invasive focused techniques, but in presence of ectopic or intrathyroidal glands, parathyroid hyperplasia or coexistent thyroid disease, the sensitivity of these imaging techniques worsens. The present study shows a new technique of preoperative scintigraphic imaging and describes the early applications of this technique investigating if it is useful in improving the localization of the pathologic parathyroid.
  
  
  METHODS
  Five female patients were enrolled in the study. In all cases, we performed a parathyroidectomy using a systematic recognition of the four parathyroid glands under intraoperative PTH monitoring, adding the use of the intraoperative gamma camera to usual surgical procedures. We evaluate the concordance of the results of the intraoperative gamma camera with the preoperative diagnosis, the intraoperative PTH monitoring and the intraoperative findings. Moreover, the results of the treatment one month after the surgical procedure were also considered.
  
  
  RESULTS
  The results of intraoperative scintigraphy were always concordant with intraoperative findings. The intraoperative PTH monitoring and the results of the follow-up confirmed the completeness of the excision, at least in a short period of observation.
  
  
  CONCLUSIONS
  The intraoperative gamma camera could help to improve the localization of a pathologic parathyroid gland. These results could be useful in improving the results of minimally invasive surgery as well as "difficult" situations.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Scerrino
authors.forename: Serena
authors.initials: S
authors.lastname: Castorina
authors.forename: Giuseppina Irene
authors.initials: GI
authors.lastname: Melfa
authors.forename: Clotilde
authors.initials: C
authors.lastname: Lo Piccolo
authors.forename: Cristina
authors.initials: C
authors.lastname: Raspanti
authors.forename: Pierina
authors.initials: P
authors.lastname: Richiusa
authors.forename: Renato Patrizio
authors.initials: RP
authors.lastname: Costa
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D005260:Female; D015902:Gamma Cameras; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D016105:Parathyroidectomy; D011877:Radionuclide Imaging