Detection of parathyroid adenoma in patients with primary hyperparathyroidism: the use of office-based ultrasound in preoperative localization

Berri, Richard N.; Lloyd, Larry R.

doi:10.1016/j.amjsurg.2005.10.027

Cited by 26 publications

(29 citation statements)

References 3 publications

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“…Kebapci et al [1] have emphasised that US sensitivity for detecting parathyroid glands, which was 34%-82% in the 1980s, greatly improved beginning in the mid-1990s, in parallel with the technological developments (highfrequency probes, colour and power Doppler), reaching the current levels of 83%-93% [1,17,[19][20][21]. In our study, the overall sensitivity of US was 84%.…”

Section: Discussionsupporting

confidence: 44%

“…A number of studies have reported a significant reduction in US sensitivity in detecting glands with lower weight compared with heavier ones; a similar, though not statistically significant, trend is reported for scintigraphy [7,15,17,27]. In our study, considering the difference between identified and missed parathyroid glands, the greatest significance was recorded in the evaluation of the two numerically balanced subgroups of scintigraphy (33 identified and 23 missed), confirming that limited spatial resolution plays a significant role in the US detection rates.…”

Section: Discussionmentioning

confidence: 73%

“…Nel lavoro di Kebapci et al [1] si sottolinea come la sensibilità dell'esame ecografico nella localizzazione delle paratiroidi, variabile dal 34% all'82% negli anni Ottanta, sia di gran lunga migliorata, di pari passo con i miglioramenti tecnologici (sonde ad alta frequenza, utilizzo di color e power doppler), dalla metà degli anni Novanta, raggiungendo valori attorno all'83%-93% [1,17,[19][20][21]. Nel nostro studio la sensibilità complessiva dell'ecografia è stata dell'84%.…”

Section: Discussionunclassified

“…In alcuni lavori si riporta una significativa riduzione di sensibilità dell'ecografia nell'identificazione di ghiandole di basso peso rispetto a quelle di peso maggiore, simile andamento, ma non statisticamente significativo, riguarda la sensibilità della scintigrafia [7,15,17,27 reported by Tublin et al [28], who obtained sensitivity and positive predictive values with US of 74% and 90%, respectively, in a study conducted on 144 patients. Their cost analysis showed that limiting the use of a third-line modality such as SPECT to cases of doubtful or negative US only can considerably reduce preoperative imaging costs.…”

Section: Discussionunclassified

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Primary hyperparathyroidism: can ultrasonography be the only preoperative diagnostic procedure?

et al. 2009

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 73%

Section: Discussionunclassified

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Primary hyperparathyroidism: can ultrasonography be the only preoperative diagnostic procedure?

et al. 2009

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“…4,5 The outcomes of surgeon-based ultrasonography (SUS) in parathyroid disease have been reported from North America and Australasia though not from the UK. [6][7][8][9][10][11][12][13][14][15] The sensitivity of SUS of 60-89% reported in these studies is equivalent or superior to radiology-based ultrasonography (RUS) and SUS has now become a useful adjunct to parathyroid surgery in these countries.…”

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confidence: 98%

The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

Aspinall

Nicholson

et al. 2012

annals

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INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit. METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT). RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS). CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

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The Diagnostic Value of Contrast‐Enhanced Ultrasound for Localization of Parathyroid Lesions in Primary Hyperparathyroidism

Piccin

D'Alessio

Serra

et al. 2022

J of Ultrasound Medicine

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Objectives Preoperative localization of pathological parathyroid glands with imaging is essential for focused unilateral neck exploration and minimally invasive techniques. Recently published studies suggested that contrast‐enhanced ultrasonography (CEUS) had high accuracy in the localization of hyperfunctioning parathyroid glands, with a general increase in the sensitivity as compared to conventional sonography. The purpose of this study was to determine the usefulness of CEUS in the localization of parathyroid lesions relating to surgical and histopathological data, in comparison to color Doppler ultrasound (CDUS), in the same series of patients. Methods Records of 142 patients who underwent parathyroidectomy were retrospectively examined comparing imaging and intraoperative/histopathologic findings. Results The overall sensitivity of CEUS was 77.6% compared with 74.6% for CDUS, although no significative differences were found (P = .516). Conversely, CDUS has shown higher sensitivity than CEUS in the group of patients with associated thyroid pathology but there was no statistical difference (P = .529). The sensitivity for detection of multiple adenomas was the same for both procedures. Conclusions We found no significative superior sensitivity of CEUS also in case of concomitant thyroid pathology and multiple glands disease.

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Detection of parathyroid adenoma in patients with primary hyperparathyroidism: the use of office-based ultrasound in preoperative localization

Cited by 26 publications

References 3 publications

Primary hyperparathyroidism: can ultrasonography be the only preoperative diagnostic procedure?

Primary hyperparathyroidism: can ultrasonography be the only preoperative diagnostic procedure?

The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

The Diagnostic Value of Contrast‐Enhanced Ultrasound for Localization of Parathyroid Lesions in Primary Hyperparathyroidism

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