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Sestamibi Scintigraphy (sestamibi + scintigraphy)
Selected AbstractsUsefulness of the combination of ultrasonography and 99mTc-sestamibi scintigraphy in the preoperative evaluation of uremic secondary hyperparathyroidismHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2010Carlo Vulpio MD Abstract Background. The usefulness of the combination of technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) parathyroid scintigraphy and ultrasonography to detect parathyroid glands (PTGs) in secondary hyperparathyroidism (SHPT) is still controversial. Methods. In all, 21 patients with SHPT underwent parathyroidectomy. The sensitivity and specificity of ultrasonography and scintigraphy related to site, size, hyperplasia type of PTG, concomitant thyroid disease, and the frequency of intraoperative frozen sections were determined. Results. The sensitivities of scintigraphy and ultrasonography were 62% and 55%, and the specificity was 95% for both procedures. The sensitivity of combined techniques was 73%. The scintigraphy detected 7/9 (78%) ectopic PTGs, whereas ultrasonography was always negative. A PTG maximum longitudinal diameter <8 mm, the presence of diffuse hyperplasia, the upper localization of glands, and the presence of concomitant thyroid disease reduced the sensitivity and specificity of imaging techniques. In cases of positive imaging, the rate of intraoperative frozen sections was significantly lower. Conclusions. The ultrasonography and sestamibi scintigraphy, which showed a higher sensitivity than that of either ultrasonography or scintigraphy alone, led to a reduction of intraoperative frozen sections and to preoperative diagnosis of ectopic (29%) or supernumerary PTGs (10%) and concomitant nodular thyroid disease (24%). © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source] Accurate localization of supernumerary mediastinal parathyroid adenomas by a combination of structural and functional imagingJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2004GC Mackie Summary Reoperation for refractory or recurrent hyperparathyroidism following parathyroidectomy carries the potential for increased morbidity and the possibility of failure to localize and remove the lesion intraoperatively. Reported herein are three cases demonstrating the combined use of sestamibi scintigraphy, CT and MR for accurate localization of mediastinal parathyroid adenomas. [source] Image-directed parathyroidectomy under local anaesthesia in the elderly,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2003L. Biertho Background: Surgical morbidity and mortality rates are increased in elderly patients. The aim of this study was to evaluate the outcome of targeted parathyroid operations in patients over the age of 70 years. Methods: Forty patients aged over 70 years underwent targeted parathyroidectomy for primary hyperparathyroidism (HPT). Data were collected prospectively and reviewed retrospectively. Results: There were 33 women and seven men with a mean age of 78 (range 70,92) years, all of whom had symptoms attributable to HPT. A solitary parathyroid adenoma was detected by ultrasonography and/or sestamibi scintigraphy before operation in all patients. Six patients had a history of neck surgery, including two with persistent or recurrent HPT. Thirty-three patients underwent neck exploration under local anaesthesia with intravenous sedation. Following parathyroidectomy, intraoperative parathyroid hormone levels normalized in 39 of 40 patients and accurately predicted postoperative eucalcaemia. Intraoperative findings included 37 solitary adenomas, one double adenoma and two carcinomas. One patient with persistent HPT developed severe hypoparathyroidism following targeted parathyroid exploration with autotransplantation. Twenty-nine patients were discharged from hospital on the day of surgery. Nineteen of 21 patients for whom data were available reported an improvement in symptoms. Conclusion: A focused neck exploration provides a safe and effective alternative to bilateral neck exploration in elderly patients in whom a solitary parathyroid adenoma has been localized before operation. Targeted parathyroidectomy under local anaesthesia is recommended in most elderly patients with HPT. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Preoperative localization of parathyroid adenomas: ultrasonography, sestamibi scintigraphy, or both?CLINICAL OTOLARYNGOLOGY, Issue 5 2004D. Hajioff Minimal access techniques are increasingly used to remove parathyroid adenomas. Such surgery depends on accurate preoperative localization but the selection of imaging modality remains controversial. We have reviewed the accuracy of ultrasonography, sestamibi scintigraphy and their combination in 48 cases of primary hyperparathyroidism. Ultrasound had a sensitivity of 64.3% (95% confidence interval 44.1,81.4) and positive predictive value (PPV) of 100% (81.5,100) for correct lateralization. Sestamibi had a sensitivity of 83.3% (69.8,92.5) and PPV of 87.1% (73.7,95.1). The simple combination of ultrasound with sestamibi had a sensitivity of 82.1% (63.1,93.9) and a PPV of 92.0% (74.0,99.0): little different from sestamibi alone. However, if the sestamibi result was disregarded in favour of ultrasonography in discordant cases, the sensitivity reached 96.4% (81.7,99.9) and the PPV was 100% (87.2,100). These results were not dependant on a learning curve or the size of adenoma. [source] | ||||||||||