Intraoperative radio-guided localization of parathyroid adenomas using 3D freehand SPECT technology.

Autor: Anesidis S; Department of Surgery, University General Hospital of Patras, Rion, 26504, Patras, Greece., Akrida I; Department of Surgery, University General Hospital of Patras, Rion, 26504, Patras, Greece. joannakrida@yahoo.gr., Michalaki M; Division of Endocrinology, Department of Internal Medicine, University General Hospital of Patras, Patras, Greece., Apostololpoulos D; Department of Nuclear Medicine, University General Hospital of Patras, Patras, Greece., Papathanasiou N; Department of Nuclear Medicine, University General Hospital of Patras, Patras, Greece., Benetatos N; Department of Surgery, University General Hospital of Patras, Rion, 26504, Patras, Greece., Kalogeropoulou C; Department of Radiology, University General Hospital of Patras, Patras, Greece., Panagopoulos K; Department of Surgery, University General Hospital of Patras, Rion, 26504, Patras, Greece., Maroulis I; Department of Surgery, University General Hospital of Patras, Rion, 26504, Patras, Greece.
Jazyk: angličtina
Zdroj: Updates in surgery [Updates Surg] 2024 Oct; Vol. 76 (6), pp. 2343-2350. Date of Electronic Publication: 2024 Mar 22.
DOI: 10.1007/s13304-024-01819-1
Abstrakt: Parathyroidectomy for primary hyperparathyroidism (PHPT) could have poor outcomes, even with accurate preoperative localization of the adenomas, because their intraoperative localization can be challenging. Freehand single photon emission computed tomography (fhSPECT) is a new technique for radio-guided intraoperative navigation. Its use during parathyroidectomy could be useful and such data are limited. We herein present our experience on the feasibility of fhSPECT for intraoperative detection of abnormal parathyroid glands. We retrospectively reviewed the clinical data of 55 patients (30-77 years old) with PHPT due to parathyroid adenomas, that were subjected to parathyroidectomy from 12/2017 to 7/2022. In average, 111 ± 74 MBq of Tc-99 m Sestamibi were injected intravenously, approximately 2 h before the operation and fhSPECT was used to generate 3D images during parathyroidectomy. Measurements of PTH and calcium levels were performed preoperatively, postoperatively and 4-6 months after the procedure. FhSPECT successfully identified the parathyroid adenoma in all the patients. It took 3 min (median time) for fhSPECT to detect at least one radioactive spot in all patients. The mean duration of the operation was 66.6 ± 7.3 min. Forty-nine patients out of 55 had solitary and 6/55 had multiple adenomas, whereas 6/55 had ectopic abnormal parathyroid glands. None of the patients had persistent hyperparathyroidism during follow-up. To the best of our knowledge, this is the largest series of patients with PHPT that underwent fhSPECT assisted parathyroidectomy. Our data suggest that this navigation system is helpful in identifying parathyroid adenomas intraoperatively.
(© 2024. Italian Society of Surgery (SIC).)
Databáze: MEDLINE
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