Combined Tc-99m sesta MIBI scintigraphy and Ultrasonography in preoperative detection and localization of parathyroid adenoma

PurposeTo evaluate the role of combined high resolution ultrasonography and technetium Tc-99m methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy in preoperative detection and localization of parathyroid adenoma, for better operative outcome.Patients and methods40 patients were included in this study, 25 of them were females and 15 were males, with age ranging between 31 and 75 (mean 46 ± 15). All patients presented with some of symptoms of hyperparathyroidism with venous blood sampling showed elevated parathyroid hormone (PTH). Parathyroid imaging was evaluated by ultrasonography, double phase Tc-99m MIBI parathyroid scintigraphy with surgical findings and results of clinical follow-up as a reference standard.ResultsAmong the 40 patients, Ultrasonography correctly identified 35 adenomas (87.5%) and MIBI scintigraphy identified 34 adenomas (85%), but when both modalities were applied together, 37 adenomas were correctly detected (92.5%).Minimally invasive parathyroidectomy under local anesthesia with unilateral incision was successfully performed in 34 (85%) patients.ConclusionsAccurate localization of adenomas should be obtained prior to surgery for minimal invasive surgical procedure. In this study, combined ultrasonography and Tc-99m MIBI improved localization of parathyroid adenomas.