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.

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.

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).

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.

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.