Abstract：
BACKGROUND: The curative treatment of primary hyperparathyroidism (PPH) is surgical and today it can be performed by minimally invasive surgery (MIS) and also be radioguided (RG) if a radiopharmaceutical with affinity for the parathyroid tissue that can be detected with gamma-detector probes or with a portable gamma camera (PGC) is injected.
OBJECTIVE: The objective is to assess whether intraoperative scintigraphy (GGio) with PGC can replace intraoperative pathological anatomy (APio) to determine if the removed specimen is an abnormal parathyroid.
METHODS: 92 patients underwent CMI RG--HPP with PGC after the administration of a dose of 99 mTc-MIBI. The information provided by the PGC in the analysis of the excised specimens is qualitatively compared (capture yes/no) with the result of the intraoperative pathological anatomy (APio). The Gold standard is the definitive histology.
RESULTS: 120 excised pieces are evaluated with GGio and APio. There were 110 agreements (95TP and 15TN) and 10 disagreements (3FP and 7FN). Of the 120 lesions, 102 were parathyroid and 18 were non-parathyroid. There was good agreement between intraoperative scintigraphy imaging (GGio) and PA, 70.1% according to Cohen\'s Kappa index. The GGio presented the following values of Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, Positive Likelihood Ratio, Negative Likelihood Ratio and Overall Value of the Test (93.1%, 83.3%, 96.9%, 68.2%, 5.59, 0.08 and 0.92 respectively).
CONCLUSIONS: GGio is a rapid and effective surgical aid technique to confirm/rule out the possible parathyroid nature of the lesions removed in PPH surgery, but it cannot replace histological study.
OBJECTIVE: The objective is to assess whether intraoperative scintigraphy (GGio) with PGC can replace intraoperative pathological anatomy (APio) to determine if the removed specimen is an abnormal parathyroid.
METHODS: 92 patients underwent CMI RG--HPP with PGC after the administration of a dose of 99 mTc-MIBI. The information provided by the PGC in the analysis of the excised specimens is qualitatively compared (capture yes/no) with the result of the intraoperative pathological anatomy (APio). The Gold standard is the definitive histology.
RESULTS: 120 excised pieces are evaluated with GGio and APio. There were 110 agreements (95TP and 15TN) and 10 disagreements (3FP and 7FN). Of the 120 lesions, 102 were parathyroid and 18 were non-parathyroid. There was good agreement between intraoperative scintigraphy imaging (GGio) and PA, 70.1% according to Cohen\'s Kappa index. The GGio presented the following values of Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, Positive Likelihood Ratio, Negative Likelihood Ratio and Overall Value of the Test (93.1%, 83.3%, 96.9%, 68.2%, 5.59, 0.08 and 0.92 respectively).
CONCLUSIONS: GGio is a rapid and effective surgical aid technique to confirm/rule out the possible parathyroid nature of the lesions removed in PPH surgery, but it cannot replace histological study.
摘要：
背景：原发性甲状旁腺功能亢进症（PPH）的治愈性治疗是外科治疗，如今，如果对甲状旁腺组织具有亲和力的放射性药物，则可以通过微创手术（MIS）进行，并且也可以进行放射性引导（RG）注射可以用γ检测器探针或便携式γ相机（PGC）检测。
目的：目的是评估PGC术中闪烁显像（GGio）是否可以替代术中病理解剖（APio），以确定切除的标本是否为异常甲状旁腺。
方法：92例患者在给予99mTc-MIBI剂量后接受CMIRG-HPP和PGC。将PGC在分析切除标本时提供的信息与术中病理解剖(AP10)的结果定性比较(捕获是/否)。黄金标准是确定的组织学。
结果：用GGio和APio评估了120个切块。有110项协议(95TP和15TN)和10项分歧(3FP和7FN)。在120个病灶中,甲状旁腺102例，非甲状旁腺18例。术中闪烁显像（GGio）和PA之间有很好的一致性，根据科恩的Kappa指数，70.1%。GGIO提出了以下灵敏度值，特异性,正预测值，负预测值，正似然比，测试的负似然比和总体值(93.1%，83.3%,96.9%,68.2%,分别为5.59、0.08和0.92）。
结论：GGio是一种快速有效的手术辅助技术，可用于确认/排除PPH手术中切除的病变可能的甲状旁腺性质，但它不能取代组织学研究。
目的：目的是评估PGC术中闪烁显像（GGio）是否可以替代术中病理解剖（APio），以确定切除的标本是否为异常甲状旁腺。
方法：92例患者在给予99mTc-MIBI剂量后接受CMIRG-HPP和PGC。将PGC在分析切除标本时提供的信息与术中病理解剖(AP10)的结果定性比较(捕获是/否)。黄金标准是确定的组织学。
结果：用GGio和APio评估了120个切块。有110项协议(95TP和15TN)和10项分歧(3FP和7FN)。在120个病灶中,甲状旁腺102例，非甲状旁腺18例。术中闪烁显像（GGio）和PA之间有很好的一致性，根据科恩的Kappa指数，70.1%。GGIO提出了以下灵敏度值，特异性,正预测值，负预测值，正似然比，测试的负似然比和总体值(93.1%，83.3%,96.9%,68.2%,分别为5.59、0.08和0.92）。
结论：GGio是一种快速有效的手术辅助技术，可用于确认/排除PPH手术中切除的病变可能的甲状旁腺性质，但它不能取代组织学研究。
