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World Journal of Surgery

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Open Access 01-01-2011

Limitations of Tc99m-MIBI-SPECT Imaging Scans in Persistent Primary Hyperparathyroidism

Authors: Janneke E. Witteveen, Job Kievit, Marcel P. M. Stokkel, Hans Morreau, Johannes A. Romijn, Neveen A. T. Hamdy

Published in: World Journal of Surgery | Issue 1/2011

Abstract

Background

In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83–100%. Data are scarce in patients undergoing reoperative parathyroidectomy for persistent hyperparathyroidism. The aim of the present study was to determine the value of Tc99m-MIBI-SPECT in localizing residual hyperactive parathyroid tissue in patients with persistent primary hyperparathyroidism (PHPT) after initial excision of one or more pathological glands.

Method

We retrospectively evaluated the localizing accuracy of Tc99m-MIBI-SPECT scans in 19 consecutive patients with persistent PHPT who had a scan before reoperative parathyroidectomy. We used as controls 23 patients with sporadic PHPT who had a scan before initial surgery.

Results

In patients with persistent PHPT, Tc99m-MIBI-SPECT accurately localized a pathological parathyroid gland in 33% of cases before reoperative parathyroidectomy, compared to 61% before first PTx for sporadic PHPT. The Tc99m-MIBI-SPECT scan accurately localized intra-thyroidal glands in 2 of 7 cases and a mediastinal gland in 1 of 3 cases either before initial or reoperative parathyroidectomy.

Conclusions

Our data suggest that the accuracy of Tc99m-MIBI-SPECT in localizing residual hyperactive glands is significantly lower before reoperative parathyroidectomy for persistent PHPT than before initial surgery for sporadic PHPT. These findings should be taken in consideration in the preoperative workup of patients with persistent primary hyperparathyroidism.

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Title: Limitations of Tc99m-MIBI-SPECT Imaging Scans in Persistent Primary Hyperparathyroidism
Authors: Janneke E. Witteveen
Job Kievit
Marcel P. M. Stokkel
Hans Morreau
Johannes A. Romijn
Neveen A. T. Hamdy
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 1/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0818-4

2024 ASCO Annual Meeting

Springer Medicine

Limitations of Tc99m-MIBI-SPECT Imaging Scans in Persistent Primary Hyperparathyroidism

Abstract

Background

Method

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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