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Table 2 Focused radioguided surgery using the 'low sestamibi dose' procedure.

From: Feasibility and long-term results of focused radioguided parathyroidectomy using a "low" 37 MBq (1 mCi) 99mTc-sestamibi protocol

(a) QPTH levels measured just before intervention and 10 min after PA removal

(b) 37 MBq (1 mCi) of 99mTc-sestamibi injected in the operating room 10 min before intervention

(c) prior to surgery, patient's neck scanned with the probe to individualize the PA

(d) a transverse midline neck 1.5 – 2 cm access, 1 cm above the sternal notch, is performed

(e) probe is repeatedly inserted through the wond guiding the surgeon to the PA.

(f) radioactivity is measured on the PA, thyroid gland and background

(g) radioactivity is measured on the ex vivo PA

(h) radioactivity is checked on the empty operating basin

(i) tissue ratios are calculated (P/B, P/T)

  1. QPTH = quick parathyroid hormone
  2. BNE = bilateral neck exploration
  3. PA = parathyroid adenoma
  4. P/B = parathyroid to background ratio
  5. P/T = parathyroid to thyroid ratio
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International Seminars in Surgical Oncology

ISSN: 1477-7800