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World Journal of Surgery

, Volume 28, Issue 6, pp 576–582 | Cite as

Usefulness of Radio-guided Surgery Using Technetium-99m Methoxyisobutylisonitrile for Primary and Secondary Hyperparathyroidism

  • Hiroshi Takeyama
  • Hisashi Shioya
  • Yutaka Mori
  • Shigeyuki Ogi
  • Hiroyasu Yamamoto
  • Naohiko Kato
  • Satoki Kinoshita
  • Kazuhiko Yoshida
  • Ken Uchida
  • Yoji Yamazaki
Original Scientific Reports

Abstract

The efficacy of technetium-99m methoxyisobutylisonitrile (99mTc-MIBI)-guided surgery for detecting abnormal parathyroid glands in patients with secondary hyperparathyroidism (2-HPT) was evaluated and compared with the results from the same examination in patients with primary hyperparathyroidism (1-HPT). The results were also compared with those found by ultrasonography (US) and preoperative 99mTc-MIBI scintigraphy was also made. At operation 99mTc-MIBI accumulated in 64 nodules of 15 cases of 2-HPT, and all of 60 parathyroid swellings were detected (true-positives 60, sensitivity 100%, accuracy 94%). In the cases of 1-HPT, 99mTc-MIBI revealed 11 hot nodules in 10 cases, and the evaluation was true-positive 10, sensitivity 100%, and accuracy 91%. US and preoperative 99mTc-MIBI scintigraphy in patients with 2-HPT had a sensitivity of 75% and 67% and an accuracy of 70% and 66%, respectively. The usefulness of 99mTc-MIBI-guided surgery for detecting abnormal parathyroid tissue in 2-HPT patients was similar to that in 1-HPT patients but was superior to US and preoperative 99mTc-MIBI scintigraphy. Intraoperative 9mTc-MIBI for patients with 2-HPT is effective and makes the surgery easier, especially when the parathyroid glands are ectopic or when a few glands are markedly enlarged but the other glands are atrophied.

Keywords

Parathyroid Gland Parathyroid Adenoma Gamma Counter Parathyroid Tissue Parathyroid Hyperplasia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2004

Authors and Affiliations

  • Hiroshi Takeyama
    • 1
  • Hisashi Shioya
    • 1
  • Yutaka Mori
    • 2
  • Shigeyuki Ogi
    • 2
  • Hiroyasu Yamamoto
    • 3
  • Naohiko Kato
    • 3
  • Satoki Kinoshita
    • 1
  • Kazuhiko Yoshida
    • 1
  • Ken Uchida
    • 1
  • Yoji Yamazaki
    • 1
  1. 1.Department of SurgeryJikei University School of MedicineTokyoJapan
  2. 2.Department of RadiologyJikei University School of MedicineTokyoJapan
  3. 3.Department of Internal MedicineJikei University School of MedicineTokyoJapan

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