Usefulness of intraoperative 99m Tc-MIBI-guided detection for recurrent sites in secondary hyperparathyroidism: a case-controlled study

Int J Surg. 2008 Jun;6(3):184-8. doi: 10.1016/j.ijsu.2008.02.006. Epub 2008 Mar 2.

Abstract

Purpose: (99m)Tc-Methoxyisobutylisonitrile ((99m)Tc-MIBI)-guided surgery for the detection of abnormal parathyroid glands in primary hyperparathyroidism (1-HPT) has gained popularity as an effective technique. However, in secondary hyperparathyroidism (2-HPT), the efficacy of this method remains controversial, especially for the recurrence sites of 2-HPT.

Methods: (99m)Tc-MIBI-guided surgery was performed for 28 recurrent sites of transplanted parathyroid tissue in 4 patients, and the detection rates of this method were compared with the results of preoperative ultrasound (US) examination and computed tomography (CT) scanning.

Results: The results of (99m)Tc-MIBI-guided surgery for regions of recurrence were a sensitivity of 100% (28/28) and an accuracy of 100% (29/29), compared with preoperative US and CT which had a sensitivity of 92.9% (26/28) and 0% (0/28), and an accuracy of 89.7% (26/29) and 0% (0/28), respectively.

Conclusions: Intraoperative (99m)Tc-MIBI-guided surgery can identify recurrent parathyroid tissues of 2-HPT more precisely than preoperative US examination or CT scanning, and makes the surgery easier to perform.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Diagnostic Imaging
  • Female
  • Humans
  • Hyperparathyroidism, Secondary / pathology
  • Hyperparathyroidism, Secondary / surgery*
  • Intraoperative Period
  • Male
  • Middle Aged
  • Parathyroid Glands / pathology
  • Parathyroid Glands / transplantation
  • Parathyroid Neoplasms / pathology
  • Parathyroid Neoplasms / surgery
  • Parathyroidectomy / methods*
  • Preoperative Care
  • Radiopharmaceuticals*
  • Recurrence
  • Sensitivity and Specificity
  • Technetium Tc 99m Sestamibi*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi