The recent development of gamma-ray probes makes it possible to perform radioguided surgery for
primary hyperparathyroidism (PHPT). There have only been a few reports, however, regarding the use of a handheld
gamma camera to detect
parathyroid adenoma intraoperatively. The aim of this preliminary study was to assess the efficiency of a
semiconductor gamma camera (eZ-SCOPE AN) in navigation surgery for PHPT. The eZ-SCOPE is designed to be used as a handheld, regional diagnostic imaging device. Eleven consecutive patients with documented
primary hyperparathyroidism underwent surgery using this compact camera. Scintigraphy images of the neck by eZ-SCOPE were acquired: 1) before skin incision; 2) after
adenoma location; 3) after
adenoma excision; and 4) ex vivo imaging of the specimen. In scan-positive cases by preoperative
Tc-MIBI, the eZ-SCOPE revealed
parathyroid adenoma in all cases (100%), whereas ultrasound and CT showed a single
adenoma in 63.6 and 72.7 per cent of cases, respectively. Navigation surgery for PHPT using the eZ-SCOPE permitted intraoperative identification and removal of
parathyroid adenoma in all cases. Scintigraphy images of the neck by eZ-SCOPE also revealed a single
adenoma even before skin incision. Our results suggest that
Tc-MIBI scintigraphy with the eZ-SCOPE is useful for navigation surgery for PHPT. The eZ-SCOPE is useful for skin marking and could be easily applied for minimally invasive radioguided
parathyroidectomy in scan-positive cases.