Combined use of a nanocarbon suspension and 99m Tc-MIBI for the intra-operative localization of the parathyroid glands.

Objective: To investigate the combined use of a nanocarbon (NC) suspension and low-dose ^99m Tc-MIBI for parathyroid localization during surgery in patients with secondary hyperparathyroidism (sHPT).
Methods: Between March 2010 and September 2015, 40 patients with sHPT were enrolled in this study and were randomized to receive either low-dose ^99m Tc-MIBI+NC (group I) or low-dose ^99m Tc-MIBI (group II). Pre- and post-operative serum levels of intact PTH (iPTH), calcium and phosphorus between groups were compared and the intra-operative radioactive counts of the parathyroid glands were measured.
Results: The post-operative iPTH level was significantly lower in patients of group I (24.2±31ng/L) than in those of group II (106±155ng/L) (P=0.03) while there were no significant differences in intra-operative parathyroid gland radioactive counts between the groups. The duration of the surgical procedure was shorter for patients of group I than patients of group II. There were no serious intra-operative or post-operative complications.
Conclusion: The combined use of an NC suspension and ^99m Tc-MIBI for patients with sHPT is strongly recommended for the localization of parathyroid glands during surgery and is likely to improve clinical outcomes for patients.
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