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High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas

BACKGROUND: Radioguided surgery using 99m-Technetium-methoxyisobutylisonitrile ((99m)Tc-MIBI) has been recommended for the surgical treatment of mediastinal parathyroid adenomas. However, high myocardial (99m)Tc-MIBI uptake may limit the feasibility of radioguided surgery in aortopulmonary window pa...

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Autores principales: Schwarzlmüller, Thomas, Brauckhoff, Katrin, Løvås, Kristian, Biermann, Martin, Brauckhoff, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003509/
https://www.ncbi.nlm.nih.gov/pubmed/24758398
http://dx.doi.org/10.1186/1471-2482-14-22
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author Schwarzlmüller, Thomas
Brauckhoff, Katrin
Løvås, Kristian
Biermann, Martin
Brauckhoff, Michael
author_facet Schwarzlmüller, Thomas
Brauckhoff, Katrin
Løvås, Kristian
Biermann, Martin
Brauckhoff, Michael
author_sort Schwarzlmüller, Thomas
collection PubMed
description BACKGROUND: Radioguided surgery using 99m-Technetium-methoxyisobutylisonitrile ((99m)Tc-MIBI) has been recommended for the surgical treatment of mediastinal parathyroid adenomas. However, high myocardial (99m)Tc-MIBI uptake may limit the feasibility of radioguided surgery in aortopulmonary window parathyroid adenoma. CASE PRESENTATION: Two female patients aged 72 (#1) and 79 years (#2) with primary hyperparathyroidism caused by parathyroid adenomas in the aortopulmonary window were operated by transsternal radioguided surgery. After intravenous injection of 370 MBq (99m)Tc-MIBI at start of surgery, the maximum radioactive intensity (as counts per second) was measured over several body regions using a gamma probe before and after removal of the parathyroid adenoma. Relative radioactivity was calculated in relation to the measured ex vivo radioactivity of the adenoma, which was set to 1.0. Both patients were cured by uneventful removal of aortopulmonary window parathyroid adenomas of 4400 (#1) and 985 mg (#2). Biochemical cure was documented by intraoperative measurement of parathyroid hormone as well as follow-up examination. Ex vivo radioactivity over the parathyroid adenomas was 196 (#1) and 855 counts per second (#2). Before parathyroidectomy, relative radioactivity over the aortopulmonary window versus the heart was found at 1.3 versus 2.6 (#1) and 1.8 versus 4.8 (#2). After removal of the adenomas, radioactivity within the aortopulmonary window was only slightly reduced. CONCLUSION: High myocardial uptake of (99m)Tc-MIBI limits the feasibility of radioguided surgery in aortopulmonary parathyroid adenoma.
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spelling pubmed-40035092014-04-30 High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas Schwarzlmüller, Thomas Brauckhoff, Katrin Løvås, Kristian Biermann, Martin Brauckhoff, Michael BMC Surg Case Report BACKGROUND: Radioguided surgery using 99m-Technetium-methoxyisobutylisonitrile ((99m)Tc-MIBI) has been recommended for the surgical treatment of mediastinal parathyroid adenomas. However, high myocardial (99m)Tc-MIBI uptake may limit the feasibility of radioguided surgery in aortopulmonary window parathyroid adenoma. CASE PRESENTATION: Two female patients aged 72 (#1) and 79 years (#2) with primary hyperparathyroidism caused by parathyroid adenomas in the aortopulmonary window were operated by transsternal radioguided surgery. After intravenous injection of 370 MBq (99m)Tc-MIBI at start of surgery, the maximum radioactive intensity (as counts per second) was measured over several body regions using a gamma probe before and after removal of the parathyroid adenoma. Relative radioactivity was calculated in relation to the measured ex vivo radioactivity of the adenoma, which was set to 1.0. Both patients were cured by uneventful removal of aortopulmonary window parathyroid adenomas of 4400 (#1) and 985 mg (#2). Biochemical cure was documented by intraoperative measurement of parathyroid hormone as well as follow-up examination. Ex vivo radioactivity over the parathyroid adenomas was 196 (#1) and 855 counts per second (#2). Before parathyroidectomy, relative radioactivity over the aortopulmonary window versus the heart was found at 1.3 versus 2.6 (#1) and 1.8 versus 4.8 (#2). After removal of the adenomas, radioactivity within the aortopulmonary window was only slightly reduced. CONCLUSION: High myocardial uptake of (99m)Tc-MIBI limits the feasibility of radioguided surgery in aortopulmonary parathyroid adenoma. BioMed Central 2014-04-23 /pmc/articles/PMC4003509/ /pubmed/24758398 http://dx.doi.org/10.1186/1471-2482-14-22 Text en Copyright © 2014 Schwarzlmüller et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Schwarzlmüller, Thomas
Brauckhoff, Katrin
Løvås, Kristian
Biermann, Martin
Brauckhoff, Michael
High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas
title High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas
title_full High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas
title_fullStr High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas
title_full_unstemmed High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas
title_short High cardiac background activity limits (99m)Tc-MIBI radioguided surgery in aortopulmonary window parathyroid adenomas
title_sort high cardiac background activity limits (99m)tc-mibi radioguided surgery in aortopulmonary window parathyroid adenomas
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003509/
https://www.ncbi.nlm.nih.gov/pubmed/24758398
http://dx.doi.org/10.1186/1471-2482-14-22
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