Day of Your Operation

Why do I get Sestamibi Scan the day of surgery?


The Sestamibi scan (parathyroid scan) was invented in 1989. Some of the techniques used world-wide for this scan were developed here at our center. Although the Sestamibi is the best scan to find parathyroid adenomas, it is still not all that good, and most hospitals don’t do it well. The quality of the scan is very dependent upon the expertise and experience of the techs doing the scan.

Our scans are absolutely the best in the world, but still these scans don’t show about 65% of all parathyroid tumors. That’s why you can’t decide who gets an operation by scan results—you can only decide who gets an operation by lab-test results. Our patients always ask us “if the scan isn’t very good, why do you get one the morning of the operation?”. The answer is simple: we don’t get the scan to find the tumor! That’s what everybody else does, but that is not what we do.

We get the scan the morning of surgery for the following reasons

  1. To give us a road map of your neck. We want to know how big your thyroid is and where it is located in your neck so we know where to make the incision.
  2. To know if you have thyroid problems such as a goiter or a thyroid nodule which may need to be addressed.
  3. To know where the tumor is NOT located. In other words, the scans are not very good at showing the tumor, but when done at high-resolution they are extremely good at telling us where the tumor is NOT located, and knowing it is not in your chest, or high in your neck is very valuable information.
  4. To make the parathyroid glands radioactive so we can measure their hormone production during the operation. As you may have seen in our operation video we can tell bad glands (making hormone) from good glands (not making hormone) by their relative amount of radioactivity because the radioactive molecule goes to the part of the parathyroid gland that is making energy for hormone production. Watch the operation video to see this in action.