Background: Technetium sestamibi imaging focuses on detecting adenomas in primary hyperparathyroidism patients scheduled for parathyroidectomy with unilateral neck exploration. However, its role in the primary resection of tertiary hyperparathyroidism patients is not yet well-defined. This study aims to analyze all data of primary and tertiary hyperparathyroidism patients who underwent parathyroidectomy after the preoperative sestamibi scan. Methodology: A cross-sectional study involved a total of 28 primary and tertiary hyperparathyroidism patients who underwent 99Tc sestamibi imaging before performing parathyroidectomy from January of 2016 to August of 2018. Data collection also involved intraoperative and histopathological findings, and preoperative biochemical values and post-operative calcium levels. Results: A total of 28 patients with a mean age of 53.89 + 14 years and a female predominance (92.9%) were included. In primary hyperparathyroidism, patients 90.5% had true positive sestamibi results and 22.2% had false-positive results, while in tertiary hyperparathyroidism patients, only 9.5% had true positive sestamibi results and 44.4% had false-positive results. Those who underwent unilateral exploration had a mean postoperative calcium level of 2.28+0.21 mmol/l, while those who underwent bilateral neck exploration showed a mean postoperative calcium level of 2.01+ 2.44 mmol/l. Conclusion: Sestamibi scanning is a highly beneficial imaging technique for localizing adenomas in primary hyperparathyroidism patients. This method can facilitate unilateral surgical approach and was found to decrease postoperative hypocalcemia. However, the usefulness of sestamibi scans in the primary resection of tertiary hyperparathyroidism patients is limited, and it does not have any significance in changing the surgical approach.
Key words: Hyperparathyroidism, sestamibi scan, adenoma, Saudi Arabia, parathyroidectomy.
|
