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.
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: W Matthew Vassy; Henry S Nelson; Matthew L Mancini; Carlos H Timaran; Nathan C Hall; Gary T Smith Journal: Am Surg Date: 2003-12 Impact factor: 0.688
Authors: Celestino P Lombardi; Marco Raffaelli; Emanuela Traini; Carmela De Crea; Salvatore M Corsello; Rocco Bellantone Journal: World J Surg Date: 2009-11 Impact factor: 3.352