Radioguided surgery in primary hyperparathyroidism: a review of the different available techniques

E Goñi-Gironés, S Fuertes-Cabero, I Blanco-Sáiz, I Casáns-Tormo, P García-Talavera San Miguel, J Martín-Gil, C Sampol-Bas, P Abreu-Sánchez, R Díaz-Expósito, S Vidal-Sicart
Revista Española de Medicina Nuclear e Imagen Molecular 2020 December 29
Parathyroidectomy has evolved over the years from bilateral neck exploration to a single gland approach using minimally invasive surgery. The precise presurgical localization of the problem gland, using functional techniques, such as double-phase scintigraphy with [99m Tc] Tc-MIBI including SPECT-CT and PET-CT with [18 F]-Choline and morphological ones, such as ultrasound have played a crucial role in this paradigm's shift. Radioguided surgery techniques have also adapted and grown with new contributions known for their indication in other fields. Thus, we currently have a wide range of techniques that have been added to the minimally invasive radioguided parathyroidectomy with [99m Tc] Tc-MIBI, which was the first on the stage and for which more experience exists. Among them, in this update, we will discuss parathyroidectomy using ultrasound-guided ROLL technique as well as with the use of 125 I seeds and finally, hybrid techniques that use radiotracer and fluorescence.

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