Irish Journal of Medical Science

, Volume 176, Issue 4, pp 283–287 | Cite as

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

  • A. D. Murphy
  • E. J. Andrews
  • A. Ishtiaq
  • A. Jawad
  • P. A. McCarthy
  • D. O’Keeffe
  • F. Dunne
  • D. S. Quill
Original Article

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

Hypercalcaemia Hyperparathyroidism Minimally invasive Parathyroid Sestamibi 

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Copyright information

© Royal Academy of Medicine in Ireland 2007

Authors and Affiliations

  • A. D. Murphy
    • 1
    • 4
  • E. J. Andrews
    • 1
  • A. Ishtiaq
    • 1
  • A. Jawad
    • 1
  • P. A. McCarthy
    • 2
  • D. O’Keeffe
    • 2
  • F. Dunne
    • 3
  • D. S. Quill
    • 1
  1. 1.Department of SurgeryUniversity College HospitalGalwayIreland
  2. 2.Department of RadiologyUniversity College HospitalGalwayIreland
  3. 3.Department of MedicineUniversity College HospitalGalwayIreland
  4. 4.BostonUSA

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