The value of early SPECT/CT and hand-held γ-camera in radio-guided surgery: a case of a hard-to-locate parathyroid adenoma.

A patient with primary hyperparathyroidism underwent radio-guided surgery by means of a γ-probe and a hand-held γ-camera. Before surgery, a parathyroid double-phase planar scintigraphy and an early SPECT/CT with 99mTc-MIBI were performed and suggested an ectopic parathyroid adenoma with early washout. The hand-held γ-camera was very useful for the localization of a parathyroid adenoma, which could not be found with the probe probably due to its faint uptake and to a high blood pool activity because it was localized next to the great vessels. Besides, it demonstrated the complete extirpation of the parathyroid tissue.