Predictive value of parathyroid scintigraphy in the preoperative evaluation of patients with primary hyperparathyroidism
| Autor: | Kurt Rasmussen, A. Arveschoug, H. Rønning, P. Vestergaard, Peer Christiansen, L. P. Larsen, Leif Mosekilde, J. Theil Nielsen |
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| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Parathyroidectomy medicine.medical_specialty Adenoma medicine.medical_treatment Diagnosis Differential Parathyroid Glands 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Spect imaging Preoperative Care medicine Humans Aged Retrospective Studies Parathyroid adenoma Aged 80 and over Tomography Emission-Computed Single-Photon Hyperparathyroidism business.industry Reproducibility of Results Gold standard (test) Middle Aged Hyperparathyroidism Primary medicine.disease 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery Radiology Technetium Tc 99m Sestamibi business Primary hyperparathyroidism |
| Zdroj: | Rasmussen, K, Larsen, L P, Arveschoug, A K, Theil Nielsen, J, Vestergaard, P, Ronning, H, Mosekilde, L & Christiansen, P M 2006, ' Predictive value of parathyroid scintigraphy in the preoperative evaluation of patients with primary hyperparathyroidism ', Scand J Surg, vol. 95, pp. 199-204 . Rasmussen, K, Larsen, LP, Arveschoug, A K, Nielsen, J T, Vestergaard, P, Ronning, H, Mosekilde, L & Christiansen, P 2006, ' Predictive value of parathyroid scintigraphy in the preoperative evaluation ofpatients with primary hyperparathyroidism. ', Scand J Surg, vol. 95, no. 3, pp. 199-204 . |
| Popis: | Background and Aims: The surgical gold standard in primary hyperparathyroidism was until recently exploration of all four parathyroid glands. Today more patients undergo minimal invasive procedures demanding more accurate preoperative localization studies. The aim of the study was to determine the positive predictive value (PPV) of parathyroid scintigraphy (PS) and to some extent ultrasonography (US), defined as the probability of finding one single adenoma on the affected side at surgery when the scans had shown one single focus. Material and Methods: Eighty-eight surgically treated patients (76 women and 12 men, 8 with multiglandular disease) were included. The PS consisted of 99mTc-sestamibi scan with dual-phase technique, both planar and SPECT imaging, followed by 99mTc-pertechnetate scan. A positive scan was defined as a single focus accumulating sestamibi. Focal lesions on US were defined as hypoechoic nodules. Results: PS was positive in 80 patients. Seventy-nine had only one focus, of which 64 were correctly localized adenomas (PPV 81%). Forty-seven of 77 US examinations were positive. In 44 there was only one focus of which 38 were correctly localized (PPV 86%). PPV was 97% when both examinations were positive. Conclusions: Both PS and US have acceptably high PPVs defined as the ability to predict whether or not one single focus represents a parathyroid adenoma. Concordant positive results were accompanied by a PPV close to 100%. |
| Databáze: | OpenAIRE |
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