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Am J Surg. 2013 Mar;205(3):269-73; discussion 273. doi: 10.1016/j.amjsurg.2013.01.001. Epub 2013 Jan 22.

Early-phase technetium-99m sestamibi scintigraphy can improve preoperative localization in primary hyperparathyroidism.

Author information

  • 1Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, K3/705 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.

Abstract

BACKGROUND:

In hyperparathyroidism, dual-phase technetium-99m sestamibi scintigraphy is important for parathyroid adenoma localization. We hypothesized that reviewing early-phase scans can increase localization in patients with primary hyperparathyroidism (PHPT).

METHODS:

We reviewed our prospectively maintained database for patients with sestamibi scans before parathyroidectomy for PHPT from 2001 to 2011. Early-phase scans were read and compared with the location of the gland(s) removed at operation.

RESULTS:

Of 902 patients identified, radiologists read 693 scans as positive. Of 209 negative scans, 141 (67%) were positive in the early phase; 135 (96%) correctly identified the side of the adenoma. Using radiologist reads, 35% of patients with negative scans and 41% of patients with falsely localized glands required bilateral exploration compared with 5% of patients with correctly localized glands.

CONCLUSIONS:

A review of early scans in patients with negative imaging increases accurate adenoma localization and allows for minimally invasive operations in more patients.

Copyright © 2013 Elsevier Inc. All rights reserved.

PMID:
23351511
[PubMed - indexed for MEDLINE]
PMCID:
PMC3640407
Free PMC Article

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