The utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidism

Ms, Lim; Jinih, Marcel; Ch, Ngai; Nm, Foley; Hp, Redmond

doi:10.1308/rcsann.2017.0016

Cited by 10 publications

(4 citation statements)

References 18 publications

(14 reference statements)

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“…It can be caused by, for example, concomitant thyroid disease, such as an undiagnosed follicular thyroid adenoma. Nevertheless, these cases are rare and usually apparent on gross examination by the operating surgeon [ 18 ]. In the present study, only two such cases were observed.…”

Section: Discussionmentioning

confidence: 99%

Individualised Timing of Radio-Guided Parathyroidectomy Using Multi-Phase SPECT/CT Increases In Vivo Sensitivity and Accuracy and Reduces Operating Time: A Randomised Clinical Trial

et al. 2021

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Background: Minimally invasive parathyroidectomy is the preferred treatment for primary hyperparathyroidism. Despite relatively accurate preoperative information, minimally invasive parathyroidectomy can be challenging, especially in the case of small and ectopic adenomas. Radio guidance aids in both in vivo identification and ex vivo confirmation of adenoma. In vivo accuracy is currently not satisfactory. The present study evaluated whether a beneficial effect (increased sensitivity, specificity, accuracy) is obtained with individualised timing of minimally invasive radio-guided parathyroidectomy (MIRGP) using preoperative multi-phase 99mTc-MIBI single photon emission computed tomography (SPECT)/computed tomography (CT). Methods: This randomised clinical trial was conducted from May 2016 to January 2020 in a tertiary referral hospital. Adult patients with primary hyperparathyroidism sent for 99mTc-MIBI SPECT/CT were included consecutively and randomly assigned to conventional (dual-phase) SPECT/CT and conventional MIRGP (group I) or multi-phase SPECT/CT and individualised MIRGP (group II). One hundred of 106 eligible patients were included, and 83 patients underwent complete intervention. Results: A total of 47 patients in group I and 35 patients in group II were analysed. Group II had a shorter operating time (p = 0.003). The in vivo sensitivity and accuracy of radio guidance was 85.1% in group I and 100% in group II (p = 0.046), and 90.4% in group I and 100% in group II (p = 0.021), respectively. We found no difference in the in vivo specificity and ex vivo parameters between groups. Conclusion: Individualised timing increased the in vivo sensitivity and accuracy of radio guidance and reduced operating time, as some parathyroid adenomas rapidly wash out the radionuclide.

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Section: Discussionmentioning

confidence: 99%

Individualised Timing of Radio-Guided Parathyroidectomy Using Multi-Phase SPECT/CT Increases In Vivo Sensitivity and Accuracy and Reduces Operating Time: A Randomised Clinical Trial

et al. 2021

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“…The principle of radionuclide-facilitated diagnosis of BC is illustrated in Figure 2. A common radionuclide cancer therapy is composed of three interconnected parts: A cancer cell-surface specific targeting molecule, a synthetic binding molecule that can specifically bind to the targeting molecule (called a linker), and a radionuclide-labeled chelator that is linked to the binding molecule (Figure 2) (57)(58)(59). All these three parts plus the specific surface marker on the cancer cells ensure the radionuclides target BC with high specificity and a high affinity, excluding potential off-target effects.…”

Section: Radionuclide Diagnosis In Breast Cancermentioning

confidence: 99%

The application of radionuclide therapy for breast cancer

Musket,

Davern,

Elam

et al. 2024

Front. Nucl. Med.

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Radionuclide-mediated diagnosis and therapy have emerged as effective and low-risk approaches to treating breast cancer. Compared to traditional anatomic imaging techniques, diagnostic radionuclide-based molecular imaging systems exhibit much greater sensitivity and ability to precisely illustrate the biodistribution and metabolic processes from a functional perspective in breast cancer; this transitions diagnosis from an invasive visualization to a noninvasive visualization, potentially ensuring earlier diagnosis and on-time treatment. Radionuclide therapy is a newly developed modality for the treatment of breast cancer in which radionuclides are delivered to tumors and/or tumor-associated targets either directly or using delivery vehicles. Radionuclide therapy has been proven to be eminently effective and to exhibit low toxicity in eliminating both primary tumors and metastases, and even undetected tumors. In addition, the specific interaction between the surface modules of the delivery vehicles and the targets on the surface of tumor cells enables radionuclide targeting therapy, and this represents an exceptional potential for this treatment in breast cancer. This article reviews the development of radionuclide molecular imaging techniques that are currently employed for early breast cancer diagnosis and both the progress and challenges of radionuclide therapy employed in breast cancer treatment.

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“…A presumptive diagnosis of PHPT was made which met criteria for surgery due to the presence of osteoporosis (11). She underwent a minimally invasive, radio-guided parathyroidectomy of the left superior parathyroid gland (12). Pathology confirmed a 1.715-g left superior parathyroid adenoma measuring 2.5 × 1.7 × 0.8 cm.…”

Section: Case Reportmentioning

confidence: 99%

Occult Primary Hyperparathyroidism: A Case Report and Review of Parathyroid Ultrasonography

Moccia¹,

Miller

Vaz

2020

AACE Clinical Case Reports

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Objective: To discuss the diagnosis and management of occult primary hyperparathyroidism. Methods: We present the biochemical and radiologic evaluation, treatment, and outcome of a woman with occult primary hyperparathyroidism which presented as an unusual neck mass on ultrasound. We also present a relevant literature review. Results: A 52-year-old female presented with Hashimoto thyroiditis and a 1.2-cm, hypoechoic oval nodule in the left upper lateral portion of the thyroid. She returned a decade later with a 2.2-cm, hypervascular mass on ultrasound. Parathyroid hormone was mildly elevated at 90 pg/mL (reference range is 15 to 65 pg/mL), but she had persistently normal levels of total serum calcium at 9.9 mg/dL (reference range is 8.7 to 10.3 mg/dL), phosphorus at 3.5 mg/dL (reference range is 2.1 to 4.5 mg/dL), and albumin at 4.4 g/dL (reference range is 3.6 to 4.8 g/dL). She had elevated ionized calcium of 5.9 mg/dL (reference range is 4.5 to 5.6 mg/dL). Computed tomography with contrast of the neck revealed an enhancing oval lesion abutting the superior pole of the left thyroid with attenuation characteristics similar though slightly different from the thyroid. 99mTc-Sestamibi scan showed increased uptake posterior to the superior aspect of the left thyroid. Bone densitometry showed osteoporosis of the left distal radius and osteopenia of the left femoral neck. Minimally invasive radio-guided parathyroidectomy was performed with normalization of parathyroid hormone. Pathology confirmed a 1.715-g parathyroid adenoma. Conclusion: Despite normal total calcium levels, clinically significant primary hyperparathyroidism may present as a large adenoma which could appear as a hypervascular neck mass on ultrasound. A high index of suspicion based on ultrasound features and measurement of ionized calcium may be helpful in diagnosing occult, but clinically relevant primary hyperparathyroidism.

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The utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidism

Cited by 10 publications

References 18 publications

Individualised Timing of Radio-Guided Parathyroidectomy Using Multi-Phase SPECT/CT Increases In Vivo Sensitivity and Accuracy and Reduces Operating Time: A Randomised Clinical Trial

Individualised Timing of Radio-Guided Parathyroidectomy Using Multi-Phase SPECT/CT Increases In Vivo Sensitivity and Accuracy and Reduces Operating Time: A Randomised Clinical Trial

The application of radionuclide therapy for breast cancer

Occult Primary Hyperparathyroidism: A Case Report and Review of Parathyroid Ultrasonography

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