Nuclear medicine techniques for radio-guided surgery of hyperparathyroidism

In recent years there has been a prominent change in surgical trends from extensive approaches to minimally invasive techniques in hyperparathyroidism. In contrast to classical bilateral exploration methods, minimally invasive parathyroidectomy necessitates an adequate preoperative imaging modality, in order to focus exactly the lesion in interest. (99m)Tc-MIBI, as a highly sensitive and widely available radiopharmaceutical, provides high success rates in terms of preoperative parathyroid lesion localization. Besides preoperative imaging, minimally invasive parathyroidectomy also requires an intraoperative modality which can act as a guide to surgeon. Hand-held gamma probes are simply-operated lesion localization devices which serve as successful intraoperative guides to surgeon. (99m)Tc-MIBI based minimal invasive parathyroidectomy has replaced the traditional 4 gland exploration as the procedure of choice in many institutions with comparable cure rates.