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Methylene Blue and Sestamibi: Complementary Tools for Localizing Parathyroids
Author(s) -
Orloff Lisa A.
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200111000-00005
Subject(s) - methylene blue , medicine , primary hyperparathyroidism , hyperparathyroidism , scintigraphy , technetium tc 99m sestamibi , parathyroid adenoma , staining , nuclear medicine , adenoma , radiology , surgery , pathology , chemistry , biochemistry , photocatalysis , catalysis
Objective To determine the value and correlation between sestamibi scan and methylene blue staining for localization of parathyroid glands in patients with primary hyperparathyroidism. Study Design Nonrandomized convenience sample, followed prospectively. Methods Twenty‐three consecutive patients underwent 24 operations for primary hyperparathyroidism. All patients underwent preoperative technetium 99m–sestamibi planar scintigraphy, preoperative administration of 7.5 mg/kg methylene blue initiated within 60 minutes of surgical incision, and surgical neck exploration supervised by a single surgeon. Results All patients were cured of hypercalcemia. Sensitivity for sestamibi and for methylene blue staining was 76% and 79%, respectively. Specificity for sestamibi and for methylene blue was 98% and 93%, respectively. Agreement between sestamibi and methylene blue was 96%. Conclusions Sestamibi scanning and methylene blue staining are useful, complementary localizing tools for patients undergoing surgery for primary hyperparathyroidism. When used together, these studies decrease operative time, justify unilateral exploration in patients with parathyroid adenoma, and increase the ease of identification of hyperplastic parathyroid glands.