An Ectopic Mediastinal Parathyroid Adenoma Accurately Located by a Single-Day Imaging Protocol of Tc-99m Pertechnetate–MIBI Subtraction Scintigraphy and MIBI-SPECT–Computed Tomographic Image Fusion

Rubello, Domenico; Casara, Dario; Fiore, Davide; Muzzio, Piercarlo; Zonzin, Giancarlo; Shapiro, Brahm

doi:10.1097/00003072-200203000-00008

Cited by 38 publications

(26 citation statements)

References 9 publications

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“…16,17 In both cases, SPECT-CT predicted the precise anatomical location of the ectopic adenoma and helped in the planning of curative surgery. 16,17 In a small prospective study of 4 patients with parathyroid hyperactivity in the mediastinum, Kaczirek et al 13 used SPECT-CT to localize ectopic parathyroid adenomas. The 4 patients showed no signs of recurrence at 16 months' follow-up.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of technetium‐99m SPECT‐CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Accuracy of technetium‐99m SPECT‐CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas

et al. 2007

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“…[20][21][22] CT-SPECT or MRI-SPE-CT image fusion appear to be superior to SPECT in preoperative imaging and can be performed on existing SPECT and CT or MRI units. [20][21][22] In our case, we did not find a pathologic parathyroid gland at the planer scintigraphy and at the MRI. The adenoma, measuring 1Χ0,5Χ0,5 cm, with a diameter greater than 1 cm, was localized by SPECT in the middle of the anterior mediastinum at the right side of the midline at both the early and thyrothymic ligament.…”

Section: Discussionmentioning

confidence: 99%

Supernumerary ectopic parathyroid glands. Persistent hyperparathyroidism due to mediastinal parathyroid adenoma localized by preoperative single photon emission computed tomography and intraoperative gamma probe application

Uludağ¹,

İşgör²,

Yetkin³

et al. 2009

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Ectopic and/or supernumerary parathyroid glands are a major cause of persistent and recurrent Hyperparathyroidism (HPT). For this reason, it is widely accepted that preoperative localization should be performed to improve the surgical results in patients with persistent or recurrent HPT. Primary HPT (pHPT) was diagnosed incidentally in a 50-year old female patient during a preoperative examination for hernia. No pathologic parathyroid gland was detected in the preoperative Tc-99m Methoxybutylisonitrile (MIBI) scintigraphy and Ultrasonography (US). Cervical exploration was performed bilaterally. Four parathyroid glands were located adjacent to the thyroid gland. A fifth was detected in front of the cricoid cartilage. All five of them were of normal histology. Postoperatively, hypercalcemia persisted. Single Photon Emission Computed Tomography (SPECT) was performed before the second operation and radioguide surgery was carried out by median sternotomy. SPECT showed a parathyroid adenoma in the middle of the anterior mediastinum which was excised (size 1x0.5x0.5 cm) using a gamma probe. In conclusion, SPECT and intraoperative gamma probe application may help to detect the parathyroid adenomas, especially if they are small in size and buried in the adipose tissue. Such localization shortens the duration of the operation and reduces the possibility of complications.

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“…A combination of scintigraphy and CT being concurrent, however, the use of catheterization might be discussed. Recent studies indicate that simultaneous acquisition of SPECT and CT images using the same imaging device provides a better anatomic localization (67,68).…”

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery as a first-line treatment for mediastinal parathyroid adenomas: strategic value of imaging

Amar

Guignat²,

Tissier³

et al. 2004

European Journal of Endocrinology

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Objective: To present first-line thoracic surgery made possible by localization studies in three patients with ectopic parathyroid adenomas. Design and methods: Three patients with ectopic parathyroid tissue in the mediastinum were examined by ultrasound, technetium-99m sestamibi scintigraphy, computed tomography (CT), and venous catheterization with measurement of parathyroid hormone. Without previous cervical exploration, video-assisted thoracic surgery (VATS) was used in all cases to avoid the need for thoracic open surgical procedures. Results and conclusions: The mediastinal parathyroid glands were all detected at scintigraphy, and CT and venous catheterization were helpful in anatomic and functioning characterization. All pathologic glands were successfully resected, with only one minor complication. VATS can safely remove a deep mediastinal parathyroid adenoma and avoid more aggressive open approaches. In an experienced referral center, systematic and sophisticated imaging studies may accurately identify and localize rare ectopic parathyroid adenomas, and avoid cervical surgery.

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An Ectopic Mediastinal Parathyroid Adenoma Accurately Located by a Single-Day Imaging Protocol of Tc-99m Pertechnetate–MIBI Subtraction Scintigraphy and MIBI-SPECT–Computed Tomographic Image Fusion

Abstract: Our experience suggests the utility of multimodality imaging procedures for the accurate preoperative localization of PAs, particularly when they are present in ectopic mediastinal locations. Such procedures, including the MIBI-SPECT-CT image fusion study, can be performed in a single day.

Cited by 38 publications

References 9 publications

Accuracy of technetium‐99m SPECT‐CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas

Accuracy of technetium‐99m SPECT‐CT hybrid images in predicting the precise intraoperative anatomical location of parathyroid adenomas

Supernumerary ectopic parathyroid glands. Persistent hyperparathyroidism due to mediastinal parathyroid adenoma localized by preoperative single photon emission computed tomography and intraoperative gamma probe application

Video-assisted thoracoscopic surgery as a first-line treatment for mediastinal parathyroid adenomas: strategic value of imaging

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