International Journal of Head and Neck Surgery

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VOLUME 6 , ISSUE 2 ( April-June, 2015 ) > List of Articles

RESEARCH ARTICLE

Preoperative Localization of Parathyroid Adenomas with Methoxyisobutylisonitrile and Ultrasonography: Are There Advantages of a Combined Approach?

Edward Ridyard

Citation Information : Ridyard E. Preoperative Localization of Parathyroid Adenomas with Methoxyisobutylisonitrile and Ultrasonography: Are There Advantages of a Combined Approach?. Int J Head Neck Surg 2015; 6 (2):45-48.

DOI: 10.5005/jp-journals-10001-1220

Published Online: 00-06-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

To identify whether the combination of Methoxyisobutylisonitrile (MIBI) and ultrasound scan (USS) in localizing the parathyroid gland preoperatively is more effective than either MIBI or USS alone.

Materials and methods

Retrospective manual analysis of patients’ operative and medical notes was undertaken. Patients presenting with raised serum calcium and parathyroid hormone (PTH) between February 2009 and April 2012 (n = 76) were included in the study.

The sensitivity of localizing parathyroid adenomas via MIBI and USS with confirmation by histological evaluation of tissue following parathyroidectomy was assessed.

Results

The combination of MIBI and USS provided a statistically significant improvement in preoperative localization of parathyroid adenoma over MIBI or USS alone (p = 0.033 and p = 0.043 respectively).

Conclusion

Ultrasound scan alone had a statistically much higher sensitivity to localize a parathyroid adenoma than MIBI and we therefore advise USS to be a first-line investigation with MIBI in reserve for when USS fails to identify an abnormality. However, the combination of both USS and MIBI provides a statistically improved preoperative visualization of parathyroid adenoma and thus reduces the risk of requiring further surgery.

How to cite this article

Ridyard E. Preoperative Localization of Parathyroid Adenomas with Methoxyisobutylisonitrile and Ultrasonography: Are There Advantages of a Combined Approach? Int J Head Neck Surg 2015;6(2):45-48.


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  1. Primary hyperparathyroidism and negative Tc99 sestamibi imaging: To operate or Not? Ann Surg Oncol. Epub ahead of print 2012 March 22.
  2. Multimodality imaging in hyperparathyroidism. Postgrad Med J 2009 Nov;85(1009):597-605.
  3. Tcm-sestamibi—a new agent for parathyroid imaging. Nucl Med Commun 1999; 10(99):791-794.
  4. Prospective evaluation of delayed technetium-99 m sestamibi SPECT scintigraphy for preoperative localization of primary hyperparathyroidism. Surg 2002;131(1):149-157.
  5. Reassessment of parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism after 2 preoperative localization studies. Arch Surg 2006 Apr;141(4):381-384.
  6. Prospective evaluation of ultrasonography plus MIBI scintigraphy in selecting patients with primary hyperparathyroidism for unilateral neck exploration under local anaesthesia. Am J Surg 2004 Mar;187(3):388-393.
  7. Can localization studies be used to direct focused parathyroid operations? Surg 2001;129(2):720-729.
  8. Does intraoperative quick parathyroid hormone assay improve the results of parathyroidectomy? World J Surg 2002;26:926-930.
  9. Hyperfunctional parathyroid glands with 99mTc-MIBI scan: semiquantitative analysis correlated with histologic findings. J Nucl Med 1999;40:1792.
  10. 99mTc-MIBI scintigraphy of parathyroid adenomas and its relation to tumour size and oxyphil cell abundance. Eur J Nucl Med 2001;28(1):209.
  11. Preoperative localization of parathyroid adenoma with sonography and 99mTc-sestamibi scintigraphy in primary hyperparathyroidism. J Clin Ultrasound 2007 May;4(1):186-190.
  12. 99MTc-sestamibi as sole technique in selection of primary hyperparathyroidism patients for unilateral neck exploration. Surgery 2008 Sep;144(3):454-459.
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