Diagnostic Localization Studies for Primary Hyperparathyroidism: A Suggested Algorithm

Preoperative ultrasound and nuclear medicine studies improve the accuracy in localization of adenoma in hyperparathyroidism

“…19 In addition, in the case of the use of US and sestamibi, a positive single lesion would warrant a unilateral exploration, two positive lesions would warrant a bilateral exploration, and no lesions would also warrant a bilateral exploration. 20 This study shows that when used together with either test showing a positive fi nding, the sensitivity increases to 82%. It should be noted that the use of nuclear imaging scans showed the highest PPV and PLR.…”

Minimally invasive procedure for resection of a parathyroid adenoma: The role of preoperative high-resolution ultrasonography

“…Others have applied Tc-sestamibi, CT, and MRI with varying degrees of success. 4,[10][11][12][13] A recently suggested option of intraoperative hand-held gamma probe did not prove to add substantially to the success of the surgical procedure. 14,15 In some studies, US sensitivity decreased in the presence of multinodular goiter and when the adenoma was located in sonographically ''silent'' regions, such as the upper mediastinum and the retroesophageal area.…”

The Diagnostic Utility of Computed Tomography for Preoperative Localization in Surgery for Hyperparathyroidism

“…In fact, several authors have demonstrated impressive results using combination algorithms of localizing techniques. For example, Weinberger and Robbins 11 reported a 93% sensitivity in 28 patients with hyperparathyroidism using tandem ultrasonography and MRI as needed for localization. Other authors have documented similarly impressive results with combined CT and ultrasonography, 12 MRI and selective venous sampling, 13 or even a combination of all popular localizing techniques 14 …”