Localization of abnormal parathyroid glands using thallium-201

Journal Article · Sun Jul 01 04:00:00 EDT 1984 · Am. J. Surg.; (United States)

DOI:https://doi.org/10.1016/0002-9610(84)90282-4· OSTI ID:6630494

MacFarlane, S D; Hanelin, L G; Taft, D A; Ryan, Jr, J A; Fredlund, P N

Ectopically located parathyroid adenomas may be difficult to find during initial neck exploration. They account for over 70 percent of missed adenomas found at reexploration. Preoperative localization of parathyroid adenomas would reduce unnecessary dissection and possibly reduce the number of negative results of initial neck exploration. Before reoperative parathyroid surgery is performed, some means of localization is mandatory to detect ectopic adenomas in the neck and mediastinum. Computed tomography and ultrasonography cannot effectively evaluate the mediastinum. Angiography and venous parathyroid hormone sampling are invasive, costly, and tedious to perform. We have shown that thallium-201 will accurately localize ectopic parathyroid adenomas. All 10 adenomas found in positions not immediately adjacent to the thyroid gland were detected by thallium-201 scintigraphy. One was a mediastinal adenoma resected with a median sternotomy. Our results suggest that thallium-201 scintigraphy should be the initial localization procedure of choice before all reexplorations. Its use before initial explorations, as well, will enable the surgeon to immediately direct attention to the area of the localized adenoma. If mediastinal uptake is found to be present, then median sternotomy may be performed during initial surgery provided a thorough neck exploration is performed first.

• Research Organization: Department of Surgery, Virginia Mason Medical Center, Seattle, Washington
• OSTI ID: 6630494
• Journal Information: Am. J. Surg.; (United States), Journal Name: Am. J. Surg.; (United States) Vol. 148:1; ISSN AJSUA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ADENOMAS
BETA DECAY RADIOISOTOPES
BODY
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENDOCRINE GLANDS
GLANDS
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NEOPLASMS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PARATHYROID GLANDS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
TOMOGRAPHY