Usefulness of the combination of ultrasonography and 99mTc‐sestamibi scintigraphy in the preoperative evaluation of uremic secondary hyperparathyroidism

Vulpio, Carlo; Bossola, Maurizio; Gaetano, A. De; Maresca, G; Bruno, Isabella; Fadda, Guido; Morassi, Francesca; Magalini, Sabina; Giordano, Alessandro; Castagneto, Marco

doi:10.1002/hed.21320

Cited by 56 publications

(65 citation statements)

References 50 publications

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“…Interoperator coefficients of variation were not studied and are therefore unavailable. According to the reported sensitivity of ultrasonography in SHPT (40), a certain number of parathyroid glands, particularly small ones, might be missed by ultrasound study. It is also possible that a few patients with an ectopic, enlarged parathyroid gland were misclassified into group S or group HS.…”

Section: Discussionmentioning

confidence: 99%

Cinacalcet Effectively Reduces Parathyroid Hormone Secretion and Gland Volume Regardless of Pretreatment Gland Size in Patients with Secondary Hyperparathyroidism

Komaba¹,

Nakanishi²,

Fujimori³

et al. 2010

Clinical Journal of the American Society of Nephrology

125

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Background and objectives: Cinacalcet is effective in reducing serum parathyroid hormone (PTH) in patients with secondary hyperparathyroidism. However, it has not been proven whether parathyroid gland size predicts response to therapy and whether cinacalcet is capable of inducing a reduction in parathyroid volume.Design, setting, participants, & measurements: This 52-week, multicenter, open-label study enrolled hemodialysis patients with moderate to severe secondary hyperparathyroidism (intact PTH >300 pg/ml). Doses of cinacalcet were adjusted between 25 and 100 mg to achieve intact PTH <180 pg/ml. Ultrasonography was performed to measure the parathyroid gland size at baseline, week 26, and week 52. Findings were also compared with those of historical controls.Results: Of the 81 subjects enrolled, 56 had parathyroid glands smaller than 500 mm 3 (group S) and 25 had at least one enlarged gland larger than 500 mm 3 (group L). Treatment with cinacalcet effectively decreased intact PTH by 55% from baseline in group S and by 58% in group L. A slightly greater proportion of patients in group S versus group L achieved an intact PTH <180 pg/ml (46 versus 32%) and a >30% reduction from baseline (88 versus 78%), but this was not statistically significant. Cinacalcet therapy also resulted in a significant reduction in parathyroid gland volume regardless of pretreatment size, which was in sharp contrast to historical controls (n ‫؍‬ 87) where parathyroid gland volume progressively increased with traditional therapy alone.Conclusions: Cinacalcet effectively decreases serum PTH levels and concomitantly reduces parathyroid gland volume, even in patients with marked parathyroid hyperplasia.

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Section: Discussionmentioning

confidence: 99%

Cinacalcet Effectively Reduces Parathyroid Hormone Secretion and Gland Volume Regardless of Pretreatment Gland Size in Patients with Secondary Hyperparathyroidism

Komaba¹,

Nakanishi²,

Fujimori³

et al. 2010

Clinical Journal of the American Society of Nephrology

125

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“…While the utility of preoperative localizing studies in multigland parathyroid disease associated with secondary HPT has been studied [30][31][32], our study is the first to analyze the utility of preoperative localizing studies in Red and blue dots represent preoperatively identified and confirmed ectopic parathyroid glands to be outside and within the thymus, respectively. Green and black dots represent ectopic parathyroid glands found intraoperatively in the thymus and in the tracheoesophageal (TE) groove, respectively patients with MEN1.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Localizing Studies for Initial Parathyroidectomy in MEN1 Syndrome: Is There Any Benefit?

et al. 2012

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In patients with MEN1, preoperative localizing studies identified a subset of ectopic glands (38%). Preoperative localizing studies may alter the operative approach in 7% of patients. Ultrasonography can detect most ectopic parathyroid glands outside thymus. This suggests that routine preoperative localizing studies to identify ectopic and supernumerary enlarged parathyroid glands is not useful in the majority of patients with MEN1 undergoing bilateral neck exploration and subtotal parathyroidectomy with cervical thymectomy.

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“…Tecnesyum-99-MIBI sintigrafi+yüksek çözünürlüklü ultrasonografinin duyarlılığı ise % 95 olarak bildirilmiştir (16). Single-photon emission computed tomography (SPECT); diğer bir metod olup özellikle daha önce paratiroid operasyonu geçiren ve re-operasyon planlanan hastalarda ektopik paratiroid dokusunun varlığını görüntülemek amaçlı kullanılan bir yöntemdir (17).…”

Section: Parathormon (Pth)unclassified

Parathyroidectomy in Hemodialysis Patients

Güngör¹,

Altunören²,

Güngör³

et al. 2016

Turk Neph Dial Transpl

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ÖZHemodiyaliz hastalarında sekonder hiperparatiroidizm tedavisi önemli bir sorundur. İlaç tedavisi çoğu zaman bu hastalarda yetersiz kalmaktadır. Paratiroid cerrahisi uygun hastalarda mutlaka akla getirilmelidir. Bu derlemede, paratiroid cerrahi teknikleri, özellikleri, sonuçları ve komplikasyonları irdelenmiştir.ANAhTAR sÖZcÜkLER: Diyaliz, Sekonder hiperparatiroidi, Paratiroidektomi AbsTRAcTTreatment of secondary hyperparathyroidism is a major problem in hemodialysis patients. Medical treatment is commonly inadequate in these patients. Parathyroid surgery should be considered in appropriate patients. In this review, we evaluate the techniques, features, results and complications of parathyroid surgery procedures.

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Usefulness of the combination of ultrasonography and 99mTc‐sestamibi scintigraphy in the preoperative evaluation of uremic secondary hyperparathyroidism

Cited by 56 publications

References 50 publications

Cinacalcet Effectively Reduces Parathyroid Hormone Secretion and Gland Volume Regardless of Pretreatment Gland Size in Patients with Secondary Hyperparathyroidism

Cinacalcet Effectively Reduces Parathyroid Hormone Secretion and Gland Volume Regardless of Pretreatment Gland Size in Patients with Secondary Hyperparathyroidism

Preoperative Localizing Studies for Initial Parathyroidectomy in MEN1 Syndrome: Is There Any Benefit?

Parathyroidectomy in Hemodialysis Patients

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