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CT-MIBI-SPECT Fusion Imaging Combined with Gamma Probe for Minimally Invasive Radioguided Parathyroidectomy (MIRP)

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Primary hyperparathyroidism (HPT) occurs in approximately 42 out of every 100,000 individuals, with women affected nearly three times more than men. It is predominantly caused by a single parathyroid adenoma, but can also be caused by glandular hyperplasia, and carcinoma. Definitive treatment for primary hyperparathyroidism remains surgical removal of affected glands, often a challenge due to the considerable anatomical variability. Minimally invasive radioguided parathyroidectomy (MIRP) is a directed surgical approach, made possible by the introduction of novel imaging techniques. Detection and precise localization of adenoma has been achieved by the use of sestamibi scans for a decade prior to the advent of computed tomography-(99m)Tc-sestamibi-single photon emission computed tomography image fusion (CT-MIBI-SPECT). In this paper, we present the use of CT-MIBI-SPECT fusion imaging in combination with a gamma probe intra-operatively as an accurate method for guided parathyroidectomy and discuss effects of the development of nuclear imaging techniques on radioguided parathyroid surgery.

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Keywords: Adenomas; CT-MIBI-SPECT; Fusion Imaging; Gamma Probe; Immunoscintigraphy; MIRP; Parathyroid hyperplasia; bilateral neck exploration; carcinoma; computed tomography; glandular hyperplasia; hypercalcemia; hyperparathyroidism; hyperparathyroidism surgery; ionized calcium; methoxy-isobutyl-isonitrile; minimally invasive radioguided parathyroidectomy; multiglandular disease; osteoporosis; parathyroid adenoma; parathyroid hormone; parathyroidectomy; primary hyperparathyroidism; radionucleotide scan; rapid parathyroid hormone; serum calcium; sestamibi scan; technetium 99; technetium-99m sestamib

Document Type: Research Article

Publication date: October 1, 2010

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  • Current Radiopharmaceuticals publishes original research articles, letters, reviews, drug clinical trial studies and guest edited issues on all aspects of research and development of radiolabelled compound preparations. The scope of the journal covers the following areas: radio imaging techniques, therapies; preparation and application of radionuclide compounds including the incorporation of tracer methods used in scientific research and applications.
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