Intraoperative 99mTc-MIBI-guided detection of ectopic glands in secondary hyperparathyroidism.

99mTc-MIBI-guided detection of abnormal parathyroid glands in primary hyperparathyroidism (1-HPT) has become a popular and effective technique, but its efficacy for detecting the ectopic glands of secondary hyperparathyroidism (2-HPT) is still controversial. Of the 2-HPT cases from 2000 to 2004, 14 ectopic parathyroid glands in 11 patients were resected using intraoperative 99mTc-MIBI scintigraphy. We evaluated and compared the results of radioguided surgery with the preoperative findings from ultrasonography (US), computed tomography (CT), and scintigraphy. The overall results for intraoperative 99mTc-MIBI-guided detection of ectopic parathyroid glands were sensitivity of 100% (14/14) and accuracy of 84.2% (16/19) compared with 42.9% (6/14) and 31.6% (6/19), respectively, for preoperative US and 50.0% (6/12) and 42.9% (6/14), respectively, for preoperative 99mTc-MIBI scintigraphy. Using intraoperative 99mTc-MIBI-guided surgery in cases of 2-HPT will ensure all ectopic parathyroid glands are detected, making the surgery easier to perform and the outcome more successful.