99MTc-sestamibi as sole technique in selection of primary hyperparathyroidism patients for unilateral neck exploration

Surgery
Dolores MoureMonica Marazuela

Abstract

Unilateral neck exploration (UNE) is becoming the procedure of choice for treatment of primary hyperparathyroidism (PHPT). The aim of this study was to evaluate the role of (99m)Tc-sestamibi (MIBI) parathyroid scintigraphy as the sole technique in selecting patients for UNE. We selected 136 consecutive PHPT patients who had only 1 solitary uptake at a MIBI were for UNE. The technique was a single dual-phase using MIBI and a subtraction technique with (99m)Tc-pertechnetate. Imaging data were correlated with surgical results. In 3 cases, the sestamibi scan was falsely positive, 1 had a contralateral location relative to the uptake, and 2 had multiglandular hyperplasia. Overall, the positive predictive value (PPV) of MIBI for detecting a solitary parathyroid adenoma in patients with 1 solitary uptake was 97.8. Sixteen patients (12%) had evidence of multinodular goiter. Overall, the PPV of MIBI was 98.4% (2 false positive among 120 cases) in patients with no multinodular thyroid disease (MNG) and 93.7% (1 false negative among 16 cases) in patients with MNG. The mean duration of the surgical procedure was 34.17 minutes. Mean hospitalization was 0.6 days. Conversion to bilateral neck exploration was performed in 5 patients. After a p...Continue Reading

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Citations

Sep 27, 2013·Canadian Journal of Surgery. Journal Canadien De Chirurgie·May C TeeSam M Wiseman
Sep 17, 2010·Indian Journal of Nuclear Medicine : IJNM : the Official Journal of the Society of Nuclear Medicine, India·Yousof Alabdulkarim, Edgard Nassif
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Oct 28, 2009·Current Opinion in Endocrinology, Diabetes, and Obesity

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