Gencoglu Esra A, Aras Murat, Moray Gokhan, Aktas Ayse
Departments of aNuclear Medicine bSurgery, Baskent University Medical Faculty, Ankara, Turkey.
Nucl Med Commun. 2014 Apr;35(4):398-404. doi: 10.1097/MNM.0000000000000056.
The aim of this study was to compare the efficacy of low-dose and high-dose (99m)Tc methoxy isobutyl isonitrile (MIBI) protocols in intraoperative localization of parathyroid adenomas by means of a gamma probe in patients with primary hyperparathyroidism (PHPT).
The study included 62 patients with PHPT who were divided into two groups. Group 1 consisted of 32 patients who were injected with a low dose (1 mCi) of (99m)Tc MIBI in the surgical suite 10 min before incision. Group 2 included 30 patients who were intravenously administered a high dose (15 mCi) of (99m)Tc MIBI 2 h before surgery. With the aid of a gamma probe, intraoperative localization of parathyroid adenomas was performed in both groups of patients who underwent minimally invasive parathyroidectomy. All lesions thought to be parathyroid adenomas were excised and subsequently evaluated histopathologically.
All parathyroid adenomas in both groups were localized and excised by means of an intraoperative gamma probe. The sensitivity, specificity, and accuracy of low-dose and high-dose (99m)Tc MIBI protocols in the intraoperative localization of adenomas in patients with PHPT were 100%.
In the light of these findings, we conclude that low-dose (99m)Tc MIBI may be preferred to intraoperative identification of parathyroid adenomas by means of a gamma probe in PHPT patients because it appears to be as effective as high-dose (99m)Tc MIBI. Moreover, the low-dose protocol does not have the disadvantages of high-dose protocol.
本研究旨在比较低剂量和高剂量（99m）锝甲氧基异丁基异腈（MIBI）方案在原发性甲状旁腺功能亢进症（PHPT）患者中通过γ探头对甲状旁腺腺瘤进行术中定位的疗效。
该研究纳入62例PHPT患者，分为两组。第1组由32例患者组成，在手术切口前10分钟于手术室内注射低剂量（1毫居里）的（99m）Tc MIBI。第2组包括30例患者，在手术前2小时静脉注射高剂量（15毫居里）的（99m）Tc MIBI。在γ探头的辅助下，对两组接受微创甲状旁腺切除术的患者进行甲状旁腺腺瘤的术中定位。所有被认为是甲状旁腺腺瘤的病变均被切除，随后进行组织病理学评估。
两组所有甲状旁腺腺瘤均通过术中γ探头定位并切除。低剂量和高剂量（99m）Tc MIBI方案在PHPT患者腺瘤术中定位的敏感性、特异性和准确性均为100%。
根据这些发现，我们得出结论，在PHPT患者中，低剂量（99m）Tc MIBI在通过γ探头术中识别甲状旁腺腺瘤方面可能更受青睐，因为它似乎与高剂量（99m）Tc MIBI一样有效。此外，低剂量方案没有高剂量方案的缺点。
