open access

Vol 68, No 4 (2017)
Original papers
Published online: 2017-05-26
Submitted: 2016-04-30
Accepted: 2016-07-14
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Minimally invasive radioguided parathyroid surgery using low-dose Tc-99m-MIBI — comparison with standard high dose

Ali Jangjoo, Ramin Sadeghi, Zohreh Mousavi, Masoud Mohebbi, Mahtab Khaje, Mehdi Asadi
DOI: 10.5603/EP.a2017.0031
·
Endokrynologia Polska 2017;68(4):398-401.

open access

Vol 68, No 4 (2017)
Original papers
Published online: 2017-05-26
Submitted: 2016-04-30
Accepted: 2016-07-14

Abstract

Introduction: Surgery remains the most effective treatment for primary hyperparathyroidism (PHPT). Minimally invasive radioguided parathyroidectomy (MIRP) is a common technique for detecting and excising abnormal parathyroid glands. The aim of this study was to compare injections of low-dose and high-dose (99m) Tc methoxy isobutyl isonitrile (MIBI) for intraoperative localisation of parathyroid adenomas by means of a gamma probe in patients with primary hyperparathyroidism (PHPT).

Material and methods: Thirty patients with PHPT and a preoperative diagnosis of parathyroid adenoma were enrolled between 2010 and 2012. They were considered as Group B and underwent MIRP using 5 mCi Tc-99m MIBI, and their perioperative data were compared with twenty patients treated with conventional 20 mCi Tc-99m MIBI previously (Group A).

Results: Group A was made up of 20 patients (mean age, 41.55 years; 14 women and 6 men), and group B included 30 patients (mean age, 40.43 years; 19 women and 11 men). The mean serum parathyroid hormone (PTH) and calcium values were recorded pre- and postoperatively. The mean follow-up period for the patients in the two groups was 18.4 and 16.5 months, respectively. Pre-operative evaluation demonstrated that the groups were statistically similar. Intraoperative data and success rate of surgery showed no difference between the two groups. No significant complication was detected after surgeries and no recurrence happened in either of the two groups during the follow-up period.

Conclusions: A new protocol of MIRP using low doses of Tc-99m-MIBI resulted in an excellent success rate. Comparing results of the study, we conclude that low-dose Tc-99m-MIBI may be preferred for identification of parathyroid adenomas intraoperatively by means of a gamma probe in PHPT patients because it appears to be as effective as high-dose Tc-99m-MIBI.

Abstract

Introduction: Surgery remains the most effective treatment for primary hyperparathyroidism (PHPT). Minimally invasive radioguided parathyroidectomy (MIRP) is a common technique for detecting and excising abnormal parathyroid glands. The aim of this study was to compare injections of low-dose and high-dose (99m) Tc methoxy isobutyl isonitrile (MIBI) for intraoperative localisation of parathyroid adenomas by means of a gamma probe in patients with primary hyperparathyroidism (PHPT).

Material and methods: Thirty patients with PHPT and a preoperative diagnosis of parathyroid adenoma were enrolled between 2010 and 2012. They were considered as Group B and underwent MIRP using 5 mCi Tc-99m MIBI, and their perioperative data were compared with twenty patients treated with conventional 20 mCi Tc-99m MIBI previously (Group A).

Results: Group A was made up of 20 patients (mean age, 41.55 years; 14 women and 6 men), and group B included 30 patients (mean age, 40.43 years; 19 women and 11 men). The mean serum parathyroid hormone (PTH) and calcium values were recorded pre- and postoperatively. The mean follow-up period for the patients in the two groups was 18.4 and 16.5 months, respectively. Pre-operative evaluation demonstrated that the groups were statistically similar. Intraoperative data and success rate of surgery showed no difference between the two groups. No significant complication was detected after surgeries and no recurrence happened in either of the two groups during the follow-up period.

Conclusions: A new protocol of MIRP using low doses of Tc-99m-MIBI resulted in an excellent success rate. Comparing results of the study, we conclude that low-dose Tc-99m-MIBI may be preferred for identification of parathyroid adenomas intraoperatively by means of a gamma probe in PHPT patients because it appears to be as effective as high-dose Tc-99m-MIBI.

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Keywords

primary hyperparathyroidism; radioguided parathyroidectomy; radiation exposure

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About this article
Title

Minimally invasive radioguided parathyroid surgery using low-dose Tc-99m-MIBI — comparison with standard high dose

Journal

Endokrynologia Polska

Issue

Vol 68, No 4 (2017)

Pages

398-401

Published online

2017-05-26

DOI

10.5603/EP.a2017.0031

Bibliographic record

Endokrynologia Polska 2017;68(4):398-401.

Keywords

primary hyperparathyroidism
radioguided parathyroidectomy
radiation exposure

Authors

Ali Jangjoo
Ramin Sadeghi
Zohreh Mousavi
Masoud Mohebbi
Mahtab Khaje
Mehdi Asadi

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