Sestamibi scan-directed, minimally invasive video-assisted parathyroidectomy: an effective treatment for solitary parathyroid adenoma.

Abstract

BACKGROUND:

Solitary adenomas have been shown to be responsible for almost 90% of cases of primary hyperparathyroidism.

AIM:

The purpose of this study was to determine the utility of sestamibi scanning pre-operatively to guide minimally invasive video-assisted (MIVA) parathyroidectomy.

METHODS:

We reviewed 40 patients who underwent parathyroidectomy between 2003 and 2004. All patients underwent a pre-operative sestamibi scan.

RESULTS:

Thirty-three (82%) patients had a localized solitary adenoma on sestamibi scan. Of these patients 29 underwent attempted MIVA parathyroidectomy. MIVA parathyroidectomy was successful in 22 patients. When pre-operative sestamibi scanning was correlated with pathological diagnosis it was shown to have a sensitivity of 82% and positive predictive value of 94%.

CONCLUSION:

Pre-operative sestamibi scan localization of a parathyroid adenoma offers a 94% positive predictive value for adenoma location. This facilitates MIVA parathyroidectomy to be used effectively to treat primary hyperparathyroidism in the majority of patients.

• Authors: A D Murphy, E J Andrews, A Ishtiaq, A Jawad, P A McCarthy, D O'Keeffe, F Dunne, D S Quill
• Journal: Irish journal of medical science (Ir J Med Sci) Vol. 176 Issue 4 Pg. 283-7 (Dec 2007) ISSN: 1863-4362 [Electronic] Ireland
• PMID: 17724570 (Publication Type: Journal Article)

Chemical References

• Technetium Tc 99m Sestamibi

Topics

• Adenoma (diagnostic imaging, surgery)
• Aged
• Cohort Studies
• Female
• Humans
• Hyperparathyroidism (diagnosis, etiology)
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures (methods)
• Neoplasm Invasiveness (pathology)
• Parathyroid Neoplasms (diagnostic imaging, surgery)
• Parathyroidectomy (methods)
• Predictive Value of Tests
• Preoperative Care
• Probability
• Risk Assessment
• Sensitivity and Specificity
• Statistics, Nonparametric
• Technetium Tc 99m Sestamibi
• Tomography, Emission-Computed, Single-Photon
• Treatment Outcome
• Video-Assisted Surgery (methods)