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Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Objective

We aimed to evaluate the effectiveness of high-dose and low-dose use of radioactive material in intraoperative gamma probe application methods in patients diagnosed with primary hyperparathyroidism and planned for surgery.

Methods

47 patients with primary hyperparathyroidism underwent minimally-invasive parathyroid surgery (MIS) after preoperative imaging studies consisting of ultrasonography (USG) and sestamibi parathyroid scintigraphy (SPS) showed a possible primary parathyroid lesion (PPL). All patients received Tc-99 sestamibi on day-of-surgery imaging (DOSI) to help with the localization of a primary parathyroid lesion (PPL) both DOSI and intraoperative gamma probe (IGP). Patients in Group I were administered 20-25 mCi Tc-99m sestamibi (methoxy isobutyl isonitrile) and images were obtained at the 20th and 120th minutes. Patients in Group II were administered 8-10 mCi doses and images were obtained at the 20th and 40th minutes. Two nuclear medicine specialists independently evaluated the images. Lesions in the localizations determined by DOSI and IGP were compared with the histopathological results of these lesions.

Results

47 patients, 35 females, and 12 males were included in the study. The mean age of 28 patients in the first group given the high dose was 54 (41-60), and the mean age was 48 (42-57) in the second group given the low dose (p=0.011). In the group given low-dose radioactive material during intraoperative gamma probe application, the observer's sensitivity, specificity, positive, and negative predictive values for finding pathology were 61.1, 100, 100, and 12.5, respectively. In the group given high-dose radioactive material, the same values were 90.9, 33.3, 50, and 83.3, respectively. While the success of MIS increases with the use of DOSI and IGP in large lesions, the success decreases with the prolongation of the accumulation time of the given dose.

Conclusion

In the intraoperative gamma probe technique used in primary hyperparathyroidism patients, the method used with low-dose radioactive material has lower sensitivity but higher specificity in estimating the post-operative pathology compared to the high-dose technique.

© 2024 Bentham Science Publishers
© 2024 The Author(s). Published by Bentham Science Publisher. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2023-07-07
2024-11-26

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/content/journals/cmir/10.2174/1573405620666230426143033
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The Comparison of Low and High-dose Scintigraphy findings in Patients with Primary Parathyroid Lesions in which Intraoperative Gamma-probe was Applied
Curr. Med. Imaging 20, e260423216210 (2024); https://doi.org/10.2174/1573405620666230426143033
/content/journals/cmir/10.2174/1573405620666230426143033
/content/journals/cmir/10.2174/1573405620666230426143033
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  • Article Type:     Research Article
Keyword(s): Gamma probe; Hyperparathyroidism; Lesions; Parathyroid adenoma; Radioactive material; Sestamibi

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