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Radioguided Parathyroidectomy

UW Health endocrine surgeons in Madison, Wisconsin, perform radioguided parathyroidectomy, which uses a gamma probe to guide incision and focus on the location of the abnormal parathyroid tissue.

 

Radioguided parathyroidectomy may also be referred to as:

  • Minimally-invasive radioguided parathyroidectomy
  • MIRP

An example of radioguided parathyroidectomyAbout Radioguided Parathyroidectomy

 

The procedure involves giving a small injection of Tc-99m sestamibi (the same agent used for the sestamibi scan, just a smaller dose) the morning of surgery. This radioactivity concentrates in the parathyroid glands allowing you to use a gamma probe to identify them during surgery.

 

A gamma probe can be used intraoperatively to guide incision placement as well as to direct the dissection, allowing the surgeon to focus in on the location of the abnormal parathyroid tissue.

 

The gamma probe is also used to confirm that the tissue resected is indeed parathyroid tissue. Radioactivity greater than 20 percent of the background is considered diagnostic for parathyroid tissue5.


Benefits of the Gamma Probe

 

The benefits of the intraoperative gamma probe have been debated. The greatest benefit appears to be in reducing operative time when it is a reoperation, the parathyroid adenoma is located in an ectopic position, or when the sestamibi scan has a false positive due to a thyroid nodule. In these cases, the radioprobe can direct the intraoperative exploration to a location of the abnormal gland.