Evaluation of Conventional Imaging Techniques on Preoperative Localization in Primary Hyperparathyroidism

Özkaya, Mesut; Elboğa, Umut; Şahin, Ertan; Kalender, Ebuzer; Korkmaz, Hakan; Demır, Hasan; Çelen, Y. Zeki; Erkılıç, Suna; Gökalp, Avni; Maralcan, Göktürk

doi:10.17305/bjbms.2015.207

Cited by 17 publications

(15 citation statements)

References 28 publications

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“…In 99mTc-MIBI imaging, this decrease in sensitivity might be associated with a delay in washout in multinodular goiter and Hashimoto's thyroiditis, whereas in USG, this decrease might be associated with the limitation of sonographic evaluation of adenoma because of a multinodular thyroid gland. However, it has been reported that benign and malign thyroid diseases might cause false positive results [22][23][24]. In our study, 33% of patients had concomitant thyroid disease.…”

Section: Discussionmentioning

confidence: 44%

“…There is concomitant thyroid pathology in 20-30% of patients with primary hyperparathyroidism [21]. The presence of thyroid pathology decreases the sensitivity of both USG and 99mTc-MIBI imaging [22][23][24]. In 99mTc-MIBI imaging, this decrease in sensitivity might be associated with a delay in washout in multinodular goiter and Hashimoto's thyroiditis, whereas in USG, this decrease might be associated with the limitation of sonographic evaluation of adenoma because of a multinodular thyroid gland.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

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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“…Furthermore, there is an association between the utility of either USG or MIBI and the weight of a parathyroid adenoma [37]. However, Ozkaya et al showed that correct identification of pathology is provided in 90.9% of cases while applying MIBI, and 87.1% with USG in patients with a single parathyroid adenoma [39]. Other studies shown the accuracy of preoperative localization of parathyroid adenomas using USG is higher (93%) comparing to MIBI (90%); the researchers have also showed that USG has higher sensitivity (98%) than MIBI (93%) [40].…”

Section: Preoperative Imaging Techniques-ultrasonography Computed Tomentioning

confidence: 99%

Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas

et al. 2020

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Accurate pre-operative determination of parathyroid glands localization is critical in the selection of minimally invasive parathyroidectomy as a surgical treatment approach in patients with primary hyperparathyroidism (PHPT). Its importance cannot be overemphasized as it helps to minimize the harmful side effects associated with damage to the parathyroid glands such as in hypocalcemia, severe hemorrhage or recurrent laryngeal nerve dysfunction. Preoperative and intraoperative methods decrease the incidence of mistakenly injuring the parathyroid glands and allow for the timely diagnosis of various abnormalities, including parathyroid adenomas. This article reviews 139 studies conducted between 1970 and 2020 (49 years). Studies that were reviewed focused on several techniques including application of carbon nanoparticles, carbon nanoparticles with technetium sestamibi (99m Tc-MIBI), Raman spectroscopy, near-infrared autofluorescence, dynamic optical contrast imaging, laser speckle contrast imaging, shear wave elastography, and indocyanine green to test their potential in providing proper parathyroid glands’ localization. Apart from reviewing the aforementioned techniques, this study focused on the applications that helped in the detection of parathyroid adenomas. Results suggest that applying all the reviewed techniques significantly improves the possibility of providing proper localization of parathyroid glands, and the application of indocyanine green has proven to be the ‘ideal’ approach for the diagnosis of parathyroid adenomas.

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“…Reaching such high diagnostic precision allows minimization of the extent of surgical procedure and gives way to applying routinely and successfully minimally invasive parathyroidectomy of the pathologically changed glands. 28 Ozkaya et al 29 evaluated the diagnostic and preoperative localization capacity of 99m Tc-sestamibi scintigraphy and US in patients with PHPT. They concluded that the overall sensitivities of 99m Tc-sestamibi scintigraphy, US and combined techniques were 85.3%, 72,5% and 90.4%, respectively.…”

Section: Parathyroid Scintigraphy With 99m Tc -Sestamibimentioning

confidence: 99%

Nuclear Medicine Methods for Evaluation of Abnormal Parathyroid Glands in Patients with Primary and Secondary Hyperparathyroidism

Botushanova¹,

Botushanov²,

M³

2017

Folia Medica

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Considered rare disease in the past, primary hyperparathyroidism (PHPT) has dramatically increased in incidence over the past thirty years with the introduction of routine calcium measurements; it is now approximately 42 per 100 000 persons. By far, the most common lesion found in patients with PHPT is the solitary parathyroid adenoma, occurring in 85%-90% of patients, while in the rest 10%- 15% primary hyperplasia of the parathyroid glands is present. Currently, the most widely used surgical approach is minimally invasive parathyroidectomy which is associated with less post-surgery complications and shorter operation time. To be successful this procedure needs to rely on a precise preoperative localization of the abnormal parathyroid glands, hence preoperative parathyroid imaging gained so large importance. The rationale for locating abnormal parathyroid tissue prior to surgery is that the glands can be notoriously unpredictable in their location. There is a general consensus that the best imaging procedure identifying abnormal parathyroid glands is the preoperative scintigraphy with 99mTc-sestamibi or 99mTc-tetrofosmin. It is characterized with high sensitivity and specificity exceeding those of ultrasound, CT or MRI. Combining scintigraphy with the other imaging techniques increases the precision for topic localization.

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Evaluation of Conventional Imaging Techniques on Preoperative Localization in Primary Hyperparathyroidism

Cited by 17 publications

References 28 publications

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

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

Preoperative and Intraoperative Methods of Parathyroid Gland Localization and the Diagnosis of Parathyroid Adenomas

Nuclear Medicine Methods for Evaluation of Abnormal Parathyroid Glands in Patients with Primary and Secondary Hyperparathyroidism

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