Postoperative parathyroid high-frequency sonography: evaluation of persistent or recurrent hyperparathyroidism

Reading, CC; Charboneau, J. William; James, E M; Karsell, PR; Grant, CS; Heerden, JA van; Dc, Purnell

doi:10.2214/ajr.144.2.399

Cited by 27 publications

(5 citation statements)

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“…A wide variety of imaging techniques has been proposed to localize parathyroid adenomata and hyperplasia. Currently, vigorous debate centers on techniques that are readily available, noninvasive, and hold promise as practical methods for parathyroid localization: thallium-technetium scintigraphy (TTS) [5][6][7][8][9][10][11][12][13], computed tomography (CT) [14][15][16][17][18][19][20][21][22][23][24], and sonography (US) [25][26][27][28][29][30][31][32][33][34][35]. We compared these 3 imaging modalities prospectively, using as the standard for comparison the surgical, pathologic, and clinical findings.…”

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confidence: 99%

Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

et al. 1986

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Controversy exists concerning the advantages and appropriateness of current imaging modalities of the localization of parathyroid tumors. We conducted a prospective, blinded study to compare the efficacy of 3 different imaging modalities in 40 patients with primary hyperparathyroidism (HPT). Patients with HPT were examined preoperatively by computer‐assisted thallium‐201/technetium‐99m scintigraphy (TTS), high‐resolution (GE 9800) computed tomography (CT), and high‐resolution (7.5 MHz) real‐time sonography (US). Each study was performed and interpreted independently. These patients then had a neck exploration and parathyroidectomy which allowed for clinical correlation of pathologic findings with the imaging results. Overall sensitivities of the 3 imaging modalities were TTS‐72%, CT‐72%, and US‐57%, with specificities of TTS‐93%, CT‐92%, and US‐96%. For lesions located below the thyroid (thymic tongue and mediastinum), sensitivities were TTS‐86%, CT‐29%, and US‐20%, all with specificities of 100%. In those HPT patients presenting with prior failed neck explorations, parathyroid tumors were detected with sensitivities of TTS‐88%, CT‐57%, and US‐67%, with specificities of 100%, 71%, and 100%, respectively. TTS with subsequent CT appears to be an optimal imaging strategy for HPT patients with prior failed neck explorations or suspected lesions below the thyroid. Since surgeons experienced in parathyroid surgery have a cure rate of 93% or greater in HPT patients without prior neck exploration, these imaging modalities may not be cost‐effective and thus not indicated for these patients.

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confidence: 99%

Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

et al. 1986

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“…Any patient scheduled for cervical reoperation. In our experience the sensitivity is 82% and specificity is 86% [7]. We would anticipate higher surgical cure rates, less extensive dissection resulting in fewer complications, and shorter operations with consequent cost savings.…”

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confidence: 71%

Invited commentary

Grant

1984

World j. surg.

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“…However, enlarged glands can be reliably detected [69]. Sonography has been shown to be helpful in the evaluation of patients with persistent or recurrent hyperparathyroidism, presumably because the abnormal glands in the neck can be identified [70]. However, difficulty and the likelihood of false-negative studies occur when the abnormal parathyroid gland is either ectopic or located in a sonographically inaccessible area, such as the retroesophageal, substernal, or mediastinal areas.…”

Section: Imaging Of Hyperparathyroidismmentioning

confidence: 99%

Diagnostic advances in APUDomas and other endocrine tumors: Imaging and localization

McLeod

Few

Shapiro

1993

Seminars in Surgical Oncology

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The different diagnostic imaging modalities available for determining the location of the various APUDomas are discussed with reference to their advantages and disadvantages. The ability to image these lesions, and to be confident in their role in the underlying pathophysiology, and clinical neuroendocrine syndrome causing symptomatology and illness, has proved to be the key to successful treatment. In many instances it is not the diagnosis that is in question, but it is the extent of disease, the location of the lesion, or whether the anatomical abnormality under study is responsible for the complicating symptoms being considered, that are the crucial questions. The ability to locate APUDomas by a variety of direct and indirect imaging or regionalizing modalities, represent a magnificent advance in the management of these tumors. It should, however, be kept in mind that no one modality or diagnostic method can uniformly be relied upon. It is evident that a multimodal, interactive medical team approach is essential to the successful overall management of patients afflicted with these fascinating tumors.

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Postoperative parathyroid high-frequency sonography: evaluation of persistent or recurrent hyperparathyroidism

Cited by 27 publications

References 0 publications

Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

Prospective comparison of radionuclide, computed tomographic, and sonographic localization of parathyroid tumors

Invited commentary

Diagnostic advances in APUDomas and other endocrine tumors: Imaging and localization

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