No abstract

No abstract

SPECT/CT provides incremental diagnostic value over SRS, mainly because of a precise anatomical localization that helps discriminate between tumour lesions and physiological uptake. SPECT/CT may detect unsuspected lesions in a small proportion of patients.

Pathological glands can be detected by the γ probe (in-vivo index>1.15) with a PPV of 97%. Although an in-vivo index greater than 1.51 is suggestive of a solitary adenoma (PPV=95%), there are a significant number of cases (27%) with lower indexes, these would erroneously lead to an extended surgery in search of a multiglandulary disease. For this reason, the combined determination of the intraoperative intact parathyroid hormone is recommended to identify multiglandulary disease.

Patients with concomitant thyroid pathology should not be a priori excluded from a MIRP, as long as other adjuvant techniques (scintigraphy or ioPTHi) are used in conjunction with the gamma probe. In these patients, the probe can also be helpful in unilateral or bilateral surgery.

No abstract

No abstract

No abstract