A prospective evaluation of preoperative localization by technetium-99m sestamibi scintigraphy and ultrasonography in primary hyperparathyroidism
| Autor: | Karen S.L. Lam, Wai-Fan Chan, Annie W. C. Kung, Brian Hung-Hin Lang, Chung-Yau Lo |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adenoma
Adult Male Technetium Tc 99m Sestamibi Parathyroidectomy medicine.medical_specialty Adolescent endocrine system diseases medicine.medical_treatment Parathyroid Diseases Scintigraphy Sensitivity and Specificity Preoperative care Technetium (99mTc) sestamibi Parathyroid Glands Preoperative Care medicine Humans Prospective Studies Radionuclide Imaging Aged Ultrasonography Parathyroid adenoma Aged 80 and over Hyperplasia medicine.diagnostic_test business.industry Organ Size General Medicine Middle Aged Hyperparathyroidism Primary medicine.disease Parathyroid Neoplasms Female Surgery Radiology business Primary hyperparathyroidism medicine.drug |
| Zdroj: | The American Journal of Surgery. 193:155-159 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2006.04.020 |
| Popis: | Background Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. Methods A total of 100 consecutive pHPT patients planning for MIP were recruited. Both USG and MIBI findings were correlated with intraoperative findings and postoperative outcome. Clinicopathologic factors were examined for potential association with a correct localizing result. Results Thirty men and 70 women (age range 13 to 93 years [median 55.5]) were included in the study. The final pathology included 98 patients with solitary adenoma and 2 patients with multiglandular disease. The sensitivities, accuracies, and positive predicted values for USG and MIBI alone were 57% vs 89%, 56% vs 85%, and 97% vs 94%, respectively. Correctly localized adenomas were significantly heavier than incorrectly localized ones. Conclusions MIBI is preferred over USG in pHPT patients planning for MIP. Weight of adenoma appeared to be the only clinicopathologic factor determining localization accuracy. |
| Databáze: | OpenAIRE |
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