Parathyroid surgery: correlation between pre‐operative localization studies and surgical outcomes

Ebner, Yaniv; Garti-Gross, Yael; Margulis, Ariel; Levy, Yair; Nabrisky, Dan; Ophir, Dov; Rotman-Pikielny, Pnina

doi:10.1111/cen.12835

Cited by 21 publications

(18 citation statements)

References 20 publications

(40 reference statements)

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“…This findings consistent with study conducted by Nasiriet al . Ectopic position parathyroid glands could not be identified by USG of neck which is consistent with other studies (7,9,10,11).…”

Section: Resultssupporting

confidence: 92%

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Sharmin

Haque

Rahman³

et al. 2019

Bangladesh J. Nuclear Med.

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Objective: Detection of parathyroid adenoma or hyperplasia/ carcinoma by imaging is very challenging.The objective of this study was to assess the imaging findings of Single-Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) in neck and thorax of patients and correlation with parathyroid hormone (PTH), Serum calcium, Inorganic phosphate(IP), Bone mineral density ( BMD) and also with neck ultrasonography (USG of neck). Material & Methods: A total 75 study subjects were included in this retrospective study conducted from January 2011 to November 2018 in the Institute of Nuclear Medicine and Allied Sciences (INMAS), SSMCH, Mitford, Dhaka. All the patients came in this institute forparathyroid SPECT-CT were included for this study. SPECT-CT findings were compared with USG of neck, serum calcium, inorganic phosphate (IP) level and BMD findings. Results: In this study 29 (38%) were male and 46(62%) were female. Mean PTH was 469±667 pg/ml, range 20-3110pg/ml, mean serum calcium 9.8±1.5 mg/dl with range 6.20 -14.30 mg/dl, mean IP3.00.8 mg/dl with range of 1.7 -4 mg/dl. SPECT-CT positive patients were 32 (42.7%) and negative patients were 43 (53.3%). USG of neck positive patients were 21 (28%) and negative patients were 54 (72%).The PTH (r=0.53, p=0.0) serum Calcium (r=0.66,p= 0.0) positively correlate with SPECT-CT positive patients and negatively with IP level (r=-0.177, p> 0.05). Among 75 the patients, 44 patients had BMD report. 28 (63.6%) patients had SPECT –CT negative findings and 16 (36.4%) patients with positive SPECT-CT findings with P value <0.05. Conclusion: This study showed the positivity of SPECT-CT parathyroid imaging positively correlate with PTH, s.ca and inversely correlate with IP. This study also showed that SPECT-CT is better than USG of neck not only localization of parathyroid gland in normal anatomical position but also in ectopic position. Bangladesh J. Nuclear Med. 21(2): 69-72, July 2018

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Section: Resultssupporting

confidence: 92%

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Sharmin

Haque

Rahman³

et al. 2019

Bangladesh J. Nuclear Med.

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“…Although the sensitivity and specificity of 99mTc-MIBI imaging is higher than those of USG, it involves low levels of radiation exposure. Unlike USG, 99mTc-MIBI imaging is not operator dependent [6]. The sensitivities of these modalities vary among centers, with a mean preoperative USG sensitivity of 76% (48-98%) for USG and of 79% (61-100%) for 99mTc-MIBI imaging [7].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of localization studies performed by various radiologists in the evaluation of parathyroid lesions

Sisman

Gül

Cander

et al. 2017

The European Research Journal

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Objective. Preoperative imaging studies are commonly used in the diagnosis of primary hyperparathyroidism to increase the success rate of surgery. In the present study, we aimed to correlate surgical outcomes with the sensitivity of localization studies that were performed by various radiologists. Methods. One hundred eightynine patients with preoperative diagnosis primary hyperparathyroidism were included. A total of 174 patients in whom hypercalcemia had been cured by parathyroidectomy, were evaluated retrospectively. In total, 184 lesions were excised from these 174 patients. Ultrasonography (USG) and technetium-99m-methoxy isobutyl isonitrile (99mTc-MIBI) imaging yielded correctly localized lesion in 74 and 108 patients, respectively. Results. The specificity of USG and 99mTc-MIBI imaging were similar (95.9% and 95.0%, respectively). However, the sensitivity was not satisfactory (45.9% for USG, 62.4% for 99mTc-MIBI). The gland size was not significant for the rate of lesion detection by 99mTc-MIBI scan or USG. Significant differences were not observed between the preoperative serum parathormone, serum calcium or 24-hour urine calcium excretion levels and the success rate of localization with either USG or 99mTc-MIBI. Conclusions. Radiologist experience in ultrasonographic parathyroid imaging was found to affect sensitivity. Therefore, surgeons, radiologists and endocrinologists that perform ultrasonographic evaluation should have extensive experience.

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“…The decision to perform minimally invasive parathyroidectomy relies on preoperative imaging localization and the specificity of such imaging tests is critical to prevent unplanned intraoperative conversion to a four-gland exploration or re-exploration surgery. Previously, several groups reported improved preoperative localization specificity of the Tc-99m sestamibi scan by combining it with other imaging modalities 29,30 or by grading the intensity of the focal activity subjectively. 31,32 We utilized the numerical ratio value to measure the degree of asymmetrical activity to interpret the initial phase image since we believe this interpretation step was most prone to erroneous and subjective interpretation.…”

Section: Discussionmentioning

confidence: 99%

Highly specific preoperative selection of solitary parathyroid adenoma cases in primary hyperparathyroidism by quantitative image analysis of the early‐phase Technetium‐99m sestamibi scan

et al. 2018

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Parathyroid surgery: correlation between pre‐operative localization studies and surgical outcomes

Cited by 21 publications

References 20 publications

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Diagnostic ability of SPECT-CT of Parathyroid Gland in correlation with different Biochemical Markers, BMD and USG of neck -Single Institute based Experience.

Sensitivity of localization studies performed by various radiologists in the evaluation of parathyroid lesions

Highly specific preoperative selection of solitary parathyroid adenoma cases in primary hyperparathyroidism by quantitative image analysis of the early‐phase Technetium‐99m sestamibi scan

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