Is Preoperative Localization in Organic Hyperinsulinism Necessary or Not?

1991 ◽  
Vol 8 (4) ◽  
pp. 220-224 ◽  
Author(s):  
T. Böttger ◽  
W. Schäfer ◽  
J. Beyer ◽  
T. Junginger
Keyword(s):  
Preoperative Localization ◽  
Organic Hyperinsulinism

Preoperative localization of parathyroid glands

2004 ◽  
Vol 43 (03) ◽  
pp. 85-90 ◽  
Author(s):  
E. Lopez Hänninen ◽  
Th. Steinmüller ◽  
T. Rohlfing ◽  
H. Bertram ◽  
M. Gutberlet ◽  
...  
Keyword(s):  
Image Fusion ◽  
Single Photon ◽  
Imaging Techniques ◽  
Photon Emission ◽  
Parathyroid Glands ◽  
Preoperative Localization ◽  
Mri Findings ◽  
99Mtc Mibi ◽  
Weighted Sequences ◽  
Mibi Scintigraphy

Summary Aim: Minimally invasive resection of hyperfunctional parathyroid glands is an alternative to open surgery. However, it requires a precise preoperative localization. This study evaluated the diagnostic use of magnetic resonance (MR) imaging, parathyroid scintigraphy, and consecutive image fusion. Patients, methods: 17 patients (9 women, 8 men; age: 29-72 years; mean: 51.2 years) with primary hyperparathyroidism were included. Examination by MRI used unenhanced T1- and T2-weighted sequences as well as contrast-enhanced T1-weighted sequences. 99mTc-MIBI scintigraphy consisted of planar and SPECT (single photon emission tomography) imaging techniques. In order to improve the anatomical localization of a scintigraphic focus, SPECT-data were fused with the corresponding MR-data using a modified version of the Express 5.0 software (Advanced Visual Systems, Waltham, MA). Results of image fusion were then compared to histopathology. Results: In 14/17 patients, a single parathyroid adenoma was found. There were 3 cases with hyperplastic glands. MRI detected 10 (71%), scintigraphy 12 (86%) adenomas. Both modalities detected 1/3 patients with hyperplasia. Image fusion improved the anatomical assignment of the 13 scintigraphic foci in five patients and was helpful in the interpretation of inconclusive MR-findings in two patients. Conclusions: Both MRI and 99mTc-MIBI scintigraphy sensitively detect parathyroid adenomas but are less reliable in case of hyperplastic glands. In case of a scintigraphic focus, image fusion considerably improves its topographic assignment. Furthermore, it facilitates the evaluation of inconclusive MRI findings.

The value of parathyroid hormone determination in ultrasound-guided fine-needle aspirates (FNA-PTH) for preoperative localization of parathyroid lesions.

2014 ◽  
Author(s):  
Magdalena Kochman ◽  
Waldemar Misiorowski ◽  
Lucyna Papierska ◽  
Elzbieta Stachlewska-Nasfeter ◽  
Witold Chudzinski ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Preoperative Localization ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Parathyroid Lesions

Preoperative Localization of Parathyroid Hyperplasia

2007 ◽  
Vol 58 (4) ◽  
pp. 398-403
Author(s):  
Shogo Shinohara ◽  
Masahiro Kikuchi ◽  
Yasushi Naito ◽  
Keizo Fujiwara ◽  
Tsunemichi Adachi ◽  
...  
Keyword(s):  
Parathyroid Hyperplasia ◽  
Preoperative Localization

S178 – Utility of CT-Sestamibi Fusion in Parathyroid Exploration

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P135-P136
Author(s):  
Michael J Clark ◽  
Phillip Pellitteri
Keyword(s):  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Image Fusion ◽  
Fusion Imaging ◽  
Parathyroid Glands ◽  
Preoperative Localization ◽  
Minimally Invasive Surgical ◽  
Sestamibi Imaging ◽  
Invasive Surgical Approach ◽  
Operative Findings

Objectives 1) Delineate the role of CT-technetium 99m sestamibi (CT-MIBI) fusion in directed parathyroidectomy. 2) Determine the clinical situations where CT-MIBI fusion would be strongly recommended. Methods Charts from 190 patients with primary hyperparathyroidism who underwent CT-MIBI mage fusion as a part of a scan directed, minimally invasive parathyroid exploration protocol were reviewed. The results of conventional sestamibi imaging and CT-MIBI image fusion were compared with operative findings. Results CT-MIBI image fusion accurately localized solitary hyperfunctional parathyroid glands in 70% of patients imaged; 55% of patients were localized with conventional sestamibi imaging. CT-MIBI fusion imaging was most accurate and predictive when conventional images suggested that the solitary gland was separated from the thyroid or when the adenoma was located in the retro-thyroidal/ retro-esophageal plane or mediastinum. Conclusions CT-MIBI image fusion is not superior to conventional sestamibi imaging when utilized for routine localization of hyperfunctional parathyroid glands. CT-MIBI fusion is of greatest benefit in guiding the directed approach to solitary glands, which are separate from the thyroid or ectopically located, regions where conventional imaging has proven to be less accurate. This imaging technique will augment the minimally invasive surgical approach in selected patients with primary hyperparathyroidism in order to further refine the focused technique. Its utility as the standard preoperative localization modality is not yet established and requires further investigation. Evaluation of differences in facility utilization with CT-MIBI image fusion and conventional sestamibi imaging may be helpful in determining its role in preoperative localization for hyperparathyroidism.

CT-MIBI image fusion: A new preoperative localization technique for primary, recurrent, and persistent hyperparathyroidism

Surgery ◽  
2004 ◽  
Vol 135 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Christoph Profanter ◽  
Gerold J Wetscher ◽  
Michael Gabriel ◽  
Tonja Sauper ◽  
Michael Rieger ◽  
...  
Keyword(s):  
Image Fusion ◽  
Preoperative Localization ◽  
Localization Technique ◽  
Persistent Hyperparathyroidism

Parathyroid sonography: A useful aid to preoperative localization

1980 ◽  
Vol 8 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Peter Duffy ◽  
Richard H. Picker ◽  
Sue Duffield ◽  
Thomas Reeve ◽  
Sue Hewlett
Keyword(s):  
Preoperative Localization

Surgical relief of the hypoglycemic state probably due to organic hyperinsulinism

1944 ◽  
Vol 65 (1) ◽  
pp. 79-87 ◽  
Author(s):  
George E. Pfeiffer ◽  
Lester H. Eisendorf
Keyword(s):  
Organic Hyperinsulinism
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