The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Arlie R Mansberger - One of the best experts on this subject based on the ideXlab platform.
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preoperative imaging of abnormal Parathyroid Glands in patients with hyperParathyroid disease using combination tc 99m pertechnetate and tc 99m sestamibi radionuclide scans
Annals of Surgery, 1994Co-Authors: George J Burke, Arlie R MansbergerAbstract:Objective To evaluate the efficacy of combined Tc-99m-pertechnetate and Tc-99m-sestamibi radionuclide scanning for imaging abnormal Parathyroid Glands in hyperParathyroid disease in a prospective study. Summary Background Data Established methods to localize abnormal Parathyroid Glands lack accuracy for routine use. Tc99m-sestamibi used in conjunction with iodine-123 has excellent potential for preoperative imaging in patients with hyperParathyroid disease. An alternative method for Parathyroid imaging was studied using Tc-99m-pertechnetate and Tc-99m-sestamibi. Methods Thirty patients with hyperParathyroid disease had Tc-99m-pertechnetate and Tc-99m-sestamibi subtraction radionuclide scanning to visualize abnormal Parathyroid Glands before surgery
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preoperative imaging of abnormal Parathyroid Glands in patients with hyperParathyroid disease using combination tc 99m pertechnetate and tc 99m sestamibi radionuclide scans
Annals of Surgery, 1994Co-Authors: George J Burke, Arlie R MansbergerAbstract:OBJECTIVE: To evaluate the efficacy of combined Tc-99m-pertechnetate and Tc-99m-sestamibi radionuclide scanning for imaging abnormal Parathyroid Glands in hyperParathyroid disease in a prospective study. SUMMARY BACKGROUND DATA: Established methods to localize abnormal Parathyroid Glands lack accuracy for routine use. Tc-99m-sestamibi used in conjunction with iodine-123 has excellent potential for preoperative imaging in patients with hyperParathyroid disease. An alternative method for Parathyroid imaging was studied using Tc-99m-pertechnetate and Tc-99m-sestamibi. METHODS: Thirty patients with hyperParathyroid disease had Tc-99m-pertechnetate and Tc-99m-sestamibi subtraction radionuclide scanning to visualize abnormal Parathyroid Glands before surgery. The patients had surgery and pathologic confirmation of all Parathyroid Glands. RESULTS: In 23 patients with primary hyperParathyroidism, 12 of 13 solitary adenomas were visualized. Six of nine patients with diffuse hyperplasia had bilateral uptake consistent with diffuse hyperplasia. Three of nine patients had negative scans. One patient previously operated on for diffuse hyperplasia had only one gland scanned. Seven patients with renal failure-associated hyperParathyroid disease were scanned: five had bilateral uptake of Tc-99m-sestamibi consistent with hyperplasia, and two who had been previously operated on had localization of remaining abnormal Parathyroid Glands. CONCLUSIONS: Tc-99m-pertechnetate combined with Tc-99m-sestamibi subtraction radionuclide scanning is less cumbersome to implement than iodine-123 combined with Tc-99m-sestamibi scanning. It has a high sensitivity for imaging solitary Parathyroid adenomas or persistent solitary hyperplastic Glands. However it does not have the resolution necessary to delineate all Parathyroid Glands in diffuse hyperplasia.
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surgical embryology and anatomy of the thyroid and Parathyroid Glands
Surgical Clinics of North America, 1993Co-Authors: Arlie R MansbergerAbstract:If morbidity during and following thyroid surgery is to be minimized or avoided, and if high rates of success are to be achieved when restoring normocalcemia in patients with primary, secondary, and tertiary hyperParathyroidism, the surgeon must be familiar with the details of the anatomy and embryology of the thyroid and Parathyroid Glands and must be fully prepared to apply that knowledge during the course of operations on those organs. This article does not describe the technical aspects of operations on the thyroid and Parathyroid Glands. Rather, it presents pertinent embryology and anatomy that should be useful to the surgeon in the decision-making process during these operations.
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prospective evaluation of the efficacy of technetium 99m sestamibi and iodine 123 radionuclide imaging of abnormal Parathyroid Glands
Surgery, 1992Co-Authors: George J Burke, Arlie R MansbergerAbstract:BACKGROUND: Technetium 99m sestamibi is an isonitrile radionuclide imaging agent that, when used with subtraction iodine 123 thyroid scans, has the potential for imaging abnormal Parathyroid Glands. METHODS: We prospectively evaluated 20 patients with hyperParathyroidism to study the efficacy of Tc 99m sestamibi and 123I subtraction radionuclide scanning for the imaging of abnormal Parathyroid Glands. All patients underwent neck exploration and histologic confirmation of all Parathyroid Glands identified. RESULTS: The solitary adenomas in 11 of 16 patients with primary hyperParathyroidism were localized with sestamibi scans. The scans in four of five patients with diffuse Parathyroid hyperplasia showed bilateral localization consistent with enlarged Glands. The fifth patient previously underwent a subtotal Parathyroidectomy, and a fifth supernumerary gland was localized with the sestamibi scan. Four patients had hyperParathyroidism related to kidney disease. Three of these had bilateral localization of enlarged Glands. The fourth patient had undergone two previous operations, and a fifth supernumerary gland was localized with the sestamibi scan. CONCLUSIONS: The preliminary data indicate that Tc 99m sestamibi in combination with 123I radionuclide scanning may be useful in the preoperative localization of abnormal Parathyroid Glands. This technique localized all of the solitary adenomas that were subsequently resected, and in two reoperative cases it identified the remaining solitary gland causing persistent hypercalcemia.
George J Burke - One of the best experts on this subject based on the ideXlab platform.
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preoperative imaging of abnormal Parathyroid Glands in patients with hyperParathyroid disease using combination tc 99m pertechnetate and tc 99m sestamibi radionuclide scans
Annals of Surgery, 1994Co-Authors: George J Burke, Arlie R MansbergerAbstract:Objective To evaluate the efficacy of combined Tc-99m-pertechnetate and Tc-99m-sestamibi radionuclide scanning for imaging abnormal Parathyroid Glands in hyperParathyroid disease in a prospective study. Summary Background Data Established methods to localize abnormal Parathyroid Glands lack accuracy for routine use. Tc99m-sestamibi used in conjunction with iodine-123 has excellent potential for preoperative imaging in patients with hyperParathyroid disease. An alternative method for Parathyroid imaging was studied using Tc-99m-pertechnetate and Tc-99m-sestamibi. Methods Thirty patients with hyperParathyroid disease had Tc-99m-pertechnetate and Tc-99m-sestamibi subtraction radionuclide scanning to visualize abnormal Parathyroid Glands before surgery
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preoperative imaging of abnormal Parathyroid Glands in patients with hyperParathyroid disease using combination tc 99m pertechnetate and tc 99m sestamibi radionuclide scans
Annals of Surgery, 1994Co-Authors: George J Burke, Arlie R MansbergerAbstract:OBJECTIVE: To evaluate the efficacy of combined Tc-99m-pertechnetate and Tc-99m-sestamibi radionuclide scanning for imaging abnormal Parathyroid Glands in hyperParathyroid disease in a prospective study. SUMMARY BACKGROUND DATA: Established methods to localize abnormal Parathyroid Glands lack accuracy for routine use. Tc-99m-sestamibi used in conjunction with iodine-123 has excellent potential for preoperative imaging in patients with hyperParathyroid disease. An alternative method for Parathyroid imaging was studied using Tc-99m-pertechnetate and Tc-99m-sestamibi. METHODS: Thirty patients with hyperParathyroid disease had Tc-99m-pertechnetate and Tc-99m-sestamibi subtraction radionuclide scanning to visualize abnormal Parathyroid Glands before surgery. The patients had surgery and pathologic confirmation of all Parathyroid Glands. RESULTS: In 23 patients with primary hyperParathyroidism, 12 of 13 solitary adenomas were visualized. Six of nine patients with diffuse hyperplasia had bilateral uptake consistent with diffuse hyperplasia. Three of nine patients had negative scans. One patient previously operated on for diffuse hyperplasia had only one gland scanned. Seven patients with renal failure-associated hyperParathyroid disease were scanned: five had bilateral uptake of Tc-99m-sestamibi consistent with hyperplasia, and two who had been previously operated on had localization of remaining abnormal Parathyroid Glands. CONCLUSIONS: Tc-99m-pertechnetate combined with Tc-99m-sestamibi subtraction radionuclide scanning is less cumbersome to implement than iodine-123 combined with Tc-99m-sestamibi scanning. It has a high sensitivity for imaging solitary Parathyroid adenomas or persistent solitary hyperplastic Glands. However it does not have the resolution necessary to delineate all Parathyroid Glands in diffuse hyperplasia.
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prospective evaluation of the efficacy of technetium 99m sestamibi and iodine 123 radionuclide imaging of abnormal Parathyroid Glands
Surgery, 1992Co-Authors: George J Burke, Arlie R MansbergerAbstract:BACKGROUND: Technetium 99m sestamibi is an isonitrile radionuclide imaging agent that, when used with subtraction iodine 123 thyroid scans, has the potential for imaging abnormal Parathyroid Glands. METHODS: We prospectively evaluated 20 patients with hyperParathyroidism to study the efficacy of Tc 99m sestamibi and 123I subtraction radionuclide scanning for the imaging of abnormal Parathyroid Glands. All patients underwent neck exploration and histologic confirmation of all Parathyroid Glands identified. RESULTS: The solitary adenomas in 11 of 16 patients with primary hyperParathyroidism were localized with sestamibi scans. The scans in four of five patients with diffuse Parathyroid hyperplasia showed bilateral localization consistent with enlarged Glands. The fifth patient previously underwent a subtotal Parathyroidectomy, and a fifth supernumerary gland was localized with the sestamibi scan. Four patients had hyperParathyroidism related to kidney disease. Three of these had bilateral localization of enlarged Glands. The fourth patient had undergone two previous operations, and a fifth supernumerary gland was localized with the sestamibi scan. CONCLUSIONS: The preliminary data indicate that Tc 99m sestamibi in combination with 123I radionuclide scanning may be useful in the preoperative localization of abnormal Parathyroid Glands. This technique localized all of the solitary adenomas that were subsequently resected, and in two reoperative cases it identified the remaining solitary gland causing persistent hypercalcemia.
Christopher Palestro - One of the best experts on this subject based on the ideXlab platform.
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radionuclide imaging of the Parathyroid Glands
Seminars in Nuclear Medicine, 2005Co-Authors: Christopher Palestro, Maria B Tomas, G G TroncoAbstract:The Parathyroid Glands, which usually are situated behind the thyroid gland, secrete Parathyroid hormone, or PTH, which helps maintain calcium homeostasis. Primary hyperParathyroidism results from excess Parathyroid hormone secretion. In secondary hyperParathyroidism, the normal PTH effect on bone calcium release is lost. Serum PTH rises, causing generalized hyperplasia. In tertiary hyperParathyroidism, a complication of secondary hyperParathyroidism, normal feedback mechanisms governing PTH secretion are lost, Parathyroid gland sensitivity to PTH decreases, and the threshold for inhibiting PTH secretion increases. 99m Tc sestamibi, or MIBI, the current radionuclide study of choice for preoperative Parathyroid localization, can be performed in various ways. The "single-isotope, double-phase technique" is based on the fact that MIBI washes out more rapidly from the thyroid than from abnormal Parathyroid tissue. However, not all Parathyroid lesions retain MIBI and not all thyroid tissue washes out quickly, and subtraction imaging is helpful. Many MIBI avid thyroid lesions also accumulate pertechnetate and iodine, and subtraction reduces false positives. Single-photon emission computed tomography provides information for localizing Parathyroid lesions, differentiating thyroid from Parathyroid lesions, and detecting and localizing ectopic Parathyroid lesions. The most frequent cause of false-positive MIBI results is the solid thyroid nodule. Other causes include thyroid carcinoma, lymphoma, and lymphadenopathy. False-negative results occur because of several factors. Lesion size is important. Cellular function also may be important. Parathyroid tissue that expresses P-glycoprotein does not accumulate MIBI. Parathyroid adenomas that express either P-glycoprotein or the multidrug resistance related protein MRP are less likely to accumulate MIBI. MIBI scintigraphy is less sensitive for detecting hyperplastic Parathyroid Glands. In secondary hyperParathyroidism, MIBI uptake is more closely related to cell cycle than to gland size. Mitochondria-rich oxyphil cells presumably account for MIBI uptake in Parathyroid lesions. Fewer oxyphil cells, and hence fewer mitochondria, may explain both lower uptake and rapid washout of MIBI from some lesions. MIBI is also less sensitive for detecting multigland disease than solitary gland disease.
Melanie L Richards - One of the best experts on this subject based on the ideXlab platform.
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imaging of the thyroid and Parathyroid Glands
Surgical Clinics of North America, 2011Co-Authors: Bianca J Vazquez, Melanie L RichardsAbstract:: Current multimodal imaging techniques offer practicing providers the adequate framework to plan and accomplish care for patients with thyroid and Parathyroid disorders. Available imaging modalities include ultrasonography (US), nuclear scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI). US remains the most cost-effective and the safest approach for the initial evaluation of the thyroid gland. Parathyroid subtraction scintigraphy provides localization of pathologic Parathyroid Glands with the greatest sensitivity. Localizing imaging studies allow for surgical planning with minimal risk and morbidity to the patient. CT scan and MRI play an adjunctive role in the further characterization of neck pathology.
G G Tronco - One of the best experts on this subject based on the ideXlab platform.
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radionuclide imaging of the Parathyroid Glands
Seminars in Nuclear Medicine, 2005Co-Authors: Christopher Palestro, Maria B Tomas, G G TroncoAbstract:The Parathyroid Glands, which usually are situated behind the thyroid gland, secrete Parathyroid hormone, or PTH, which helps maintain calcium homeostasis. Primary hyperParathyroidism results from excess Parathyroid hormone secretion. In secondary hyperParathyroidism, the normal PTH effect on bone calcium release is lost. Serum PTH rises, causing generalized hyperplasia. In tertiary hyperParathyroidism, a complication of secondary hyperParathyroidism, normal feedback mechanisms governing PTH secretion are lost, Parathyroid gland sensitivity to PTH decreases, and the threshold for inhibiting PTH secretion increases. 99m Tc sestamibi, or MIBI, the current radionuclide study of choice for preoperative Parathyroid localization, can be performed in various ways. The "single-isotope, double-phase technique" is based on the fact that MIBI washes out more rapidly from the thyroid than from abnormal Parathyroid tissue. However, not all Parathyroid lesions retain MIBI and not all thyroid tissue washes out quickly, and subtraction imaging is helpful. Many MIBI avid thyroid lesions also accumulate pertechnetate and iodine, and subtraction reduces false positives. Single-photon emission computed tomography provides information for localizing Parathyroid lesions, differentiating thyroid from Parathyroid lesions, and detecting and localizing ectopic Parathyroid lesions. The most frequent cause of false-positive MIBI results is the solid thyroid nodule. Other causes include thyroid carcinoma, lymphoma, and lymphadenopathy. False-negative results occur because of several factors. Lesion size is important. Cellular function also may be important. Parathyroid tissue that expresses P-glycoprotein does not accumulate MIBI. Parathyroid adenomas that express either P-glycoprotein or the multidrug resistance related protein MRP are less likely to accumulate MIBI. MIBI scintigraphy is less sensitive for detecting hyperplastic Parathyroid Glands. In secondary hyperParathyroidism, MIBI uptake is more closely related to cell cycle than to gland size. Mitochondria-rich oxyphil cells presumably account for MIBI uptake in Parathyroid lesions. Fewer oxyphil cells, and hence fewer mitochondria, may explain both lower uptake and rapid washout of MIBI from some lesions. MIBI is also less sensitive for detecting multigland disease than solitary gland disease.
