Combined Tc-99m sesta MIBI scin

Abstract

Purpose: To evaluate the role of combined high resolution ultrasonography and technetium Tc-99m methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy in preoperative detection and localization of parathyroid adenoma, for better operative outcome. Patients and methods: 40 patients were included in this study, 25 of them were females and 15 were males, with age ranging between 31 and 75 (mean 46 ± 15). All patients presented with some of symptoms of hyperparathyroidism with venous blood sampling showed elevated parathyroid hormone (PTH). Parathyroid imaging was evaluated by ultrasonography, double phase Tc-99m MIBI parathyroid scintigraphy with surgical findings and results of clinical follow-up as a reference standard. Results: Among the 40 patients, Ultrasonography correctly identified 35 adenomas (87.5%) and MIBI scintigraphy identified 34 adenomas (85%), but when both modalities were applied together, 37 adenomas were correctly detected (92.5%). Minimally invasive parathyroidectomy under local anesthesia with unilateral incision was successfully performed in 34 (85%) patients. Conclusions: Accurate localization of adenomas should be obtained prior to surgery for minimal invasive surgical procedure. In this study, combined ultrasonography and Tc-99m MIBI improved localization of parathyroid adenomas.

Keywords

• Tc-99m sesta MIBI scintigraphy
• Ultrasonography
• Parathyroid adenoma