Irish Journal of Medical Science

, Volume 176, Issue 4, pp 283–287

Sestamibi scan-directed, minimally invasive video-assisted parathyroidectomy: an effective treatment for solitary parathyroid adenoma

Authors

    • Department of SurgeryUniversity College Hospital
  • E. J. Andrews
    • Department of SurgeryUniversity College Hospital
  • A. Ishtiaq
    • Department of SurgeryUniversity College Hospital
  • A. Jawad
    • Department of SurgeryUniversity College Hospital
  • P. A. McCarthy
    • Department of RadiologyUniversity College Hospital
  • D. O’Keeffe
    • Department of RadiologyUniversity College Hospital
  • F. Dunne
    • Department of MedicineUniversity College Hospital
  • D. S. Quill
    • Department of SurgeryUniversity College Hospital
Original Article

DOI: 10.1007/s11845-007-0075-1

Cite this article as:
Murphy, A.D., Andrews, E.J., Ishtiaq, A. et al. Ir J Med Sci (2007) 176: 283. doi:10.1007/s11845-007-0075-1

Abstract

Background

Solitary adenomas have been shown to be responsible for almost 90% of cases of primary hyperparathyroidism.

Aim

The purpose of this study was to determine the utility of sestamibi scanning pre-operatively to guide minimally invasive video-assisted (MIVA) parathyroidectomy.

Methods

We reviewed 40 patients who underwent parathyroidectomy between 2003 and 2004. All patients underwent a pre-operative sestamibi scan.

Results

Thirty-three (82%) patients had a localized solitary adenoma on sestamibi scan. Of these patients 29 underwent attempted MIVA parathyroidectomy. MIVA parathyroidectomy was successful in 22 patients. When pre-operative sestamibi scanning was correlated with pathological diagnosis it was shown to have a sensitivity of 82% and positive predictive value of 94%.

Conclusion

Pre-operative sestamibi scan localization of a parathyroid adenoma offers a 94% positive predictive value for adenoma location. This facilitates MIVA parathyroidectomy to be used effectively to treat primary hyperparathyroidism in the majority of patients.

Keywords

HypercalcaemiaHyperparathyroidismMinimally invasiveParathyroidSestamibi

Copyright information

© Royal Academy of Medicine in Ireland 2007