Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy

Preoperative parathyroid evaluation through nuclear medicine and intraoperative hormone monitoring has significantly increased the success of the surgical intervention. Material and method: Our study is descriptive, the database is retrospective but it is maintained prospectively. The preoperative p...

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Main Authors: Iulian SLAVU, Cornelia NITIPIR, Cristina ORLOV-SLAVU, Alexandru DOGARU, Raluca TULIN, Constantin OPRESCU, Adrian TULIN
Format: Article
Language:English
Published: Bucharest College of Physicians 2023-06-01
Series:Modern Medicine
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Online Access:https://medicinamoderna.ro/wp-content/uploads/2023/06/Intraoperative-Post-parathyroidectomy-Correlation-of-PTH-Hormone-Values-with-Preoperative-Scintigraphy.pdf
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author Iulian SLAVU
Cornelia NITIPIR
Cristina ORLOV-SLAVU
Alexandru DOGARU
Raluca TULIN
Constantin OPRESCU
Adrian TULIN
author_facet Iulian SLAVU
Cornelia NITIPIR
Cristina ORLOV-SLAVU
Alexandru DOGARU
Raluca TULIN
Constantin OPRESCU
Adrian TULIN
author_sort Iulian SLAVU
collection DOAJ
description Preoperative parathyroid evaluation through nuclear medicine and intraoperative hormone monitoring has significantly increased the success of the surgical intervention. Material and method: Our study is descriptive, the database is retrospective but it is maintained prospectively. The preoperative protocol included single photon emission computed tomography (SPECT) with the use of technetium-99 sestamibi tracer. We preferred this approach as it allowed 3-D localization of the adenomas. PTH values were obtained from blood drawn from the ipsilateral jugular vein at the regular intervals of 5, 10 and 15 minutes post excision. Results: We had 6 cases with false negative which led to the necessary dissection of the contralateral neck. Two had previous surgery and 4 had tumors in other locations which were observed after the surgical intervention through methodical investigations. We encountered 3 patients with false positive results. 2 had intrathyroidal adenomas and 1 was diagnosed with thyroid papillary carcinoma. Causes of a misinterpretation are related to thyroid disease in association with hyperparathyroidism, a history of parathyroid surgery or multiple locations of hyperproductive parathyroid glands.
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language English
publishDate 2023-06-01
publisher Bucharest College of Physicians
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spelling doaj-art-7b1d7d72fa7d4c77a8a29e85d3153eae2025-08-20T02:07:02ZengBucharest College of PhysiciansModern Medicine1223-04722360-24732023-06-013029599https://doi.org/10.31689/rmm.2023.30.2.95Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative ScintigraphyIulian SLAVU0Cornelia NITIPIR1https://orcid.org/0000-0002-5985-3759Cristina ORLOV-SLAVU2Alexandru DOGARU3Raluca TULIN4Constantin OPRESCU5Adrian TULIN6Anatomy Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, RomaniaOncology Department of the University of Medicine and Pharmacy “Carol Davila”, Bucharest, "Elias" Hospital, RomaniaOncology Department of the University of Medicine and Pharmacy “Carol Davila”, Bucharest, "Elias" Hospital, RomaniaAnatomy Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, RomaniaEndocrinology Department of the University of Medicine and Pharmacy “Carol Davila”, Bucharest, "Agrippa Ionescu" Hospital, RomaniaGeneral Surgery Department of the University of Medicine and Pharmacy “Carol Davila”, Bucharest, "Floreasca" Hospital, RomaniaGeneral Surgery Department of the University of Medicine and Pharmacy “Carol Davila”, Bucharest, "Floreasca" Hospital, RomaniaPreoperative parathyroid evaluation through nuclear medicine and intraoperative hormone monitoring has significantly increased the success of the surgical intervention. Material and method: Our study is descriptive, the database is retrospective but it is maintained prospectively. The preoperative protocol included single photon emission computed tomography (SPECT) with the use of technetium-99 sestamibi tracer. We preferred this approach as it allowed 3-D localization of the adenomas. PTH values were obtained from blood drawn from the ipsilateral jugular vein at the regular intervals of 5, 10 and 15 minutes post excision. Results: We had 6 cases with false negative which led to the necessary dissection of the contralateral neck. Two had previous surgery and 4 had tumors in other locations which were observed after the surgical intervention through methodical investigations. We encountered 3 patients with false positive results. 2 had intrathyroidal adenomas and 1 was diagnosed with thyroid papillary carcinoma. Causes of a misinterpretation are related to thyroid disease in association with hyperparathyroidism, a history of parathyroid surgery or multiple locations of hyperproductive parathyroid glands.https://medicinamoderna.ro/wp-content/uploads/2023/06/Intraoperative-Post-parathyroidectomy-Correlation-of-PTH-Hormone-Values-with-Preoperative-Scintigraphy.pdfhyperparathyroidismsestaimibisurgery
spellingShingle Iulian SLAVU
Cornelia NITIPIR
Cristina ORLOV-SLAVU
Alexandru DOGARU
Raluca TULIN
Constantin OPRESCU
Adrian TULIN
Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy
Modern Medicine
hyperparathyroidism
sestaimibi
surgery
title Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy
title_full Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy
title_fullStr Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy
title_full_unstemmed Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy
title_short Intraoperative Post-parathyroidectomy Correlation of PTH Hormone Values with Preoperative Scintigraphy
title_sort intraoperative post parathyroidectomy correlation of pth hormone values with preoperative scintigraphy
topic hyperparathyroidism
sestaimibi
surgery
url https://medicinamoderna.ro/wp-content/uploads/2023/06/Intraoperative-Post-parathyroidectomy-Correlation-of-PTH-Hormone-Values-with-Preoperative-Scintigraphy.pdf
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