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

  • 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 

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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