Neck Exploration Versus Imaging Localization of Parathyroid in Secondary Hyperparathyroidism

Elsageer, Emad; Shehata, Adel; Khalaf, Mohamed; El-Heeny, Amr Abd El-Hameed

doi:10.1007/s12262-018-1842-0

Cited by 2 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median age of PHPT patients was 63 year and the median age of SHPT patients was 34 years with significant difference in our study. This result is consistent with the reported mean age of PHPT patients and the group age of SHPT mentioned in the study ( 2 , 35 , 36 ). The age of SHPT patients become younger with the degree of disease ( 37 ).…”

Section: Discussionsupporting

confidence: 93%

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

Wang

Liu

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

ObjectiveTo investigate the differences in biochemical marker levels and the extent of lesion visualization on technetium 99m methoxyisobutylisonitrile (99mTc-MIBI) imaging between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT).MethodsNineteen patients with PHPT and 14 patients with SHPT were enrolled in the study, all of whom underwent routine 99mTc-MIBI dual-phase planar imaging, single-photon emission computed tomography combined with computed tomography (SPECT/CT fusion) imaging, and serum biochemical and hormonal investigations prior to surgery. The target-to-non-target (T/NT) ratios were calculated based on images from the early and delayed phases of 99mTc-MIBI planar imaging and also based on SPECT/CT fusion imaging. The volume of the parathyroid glands was measured following their excision.ResultsA total of 62 parathyroid glands were removed: 14 parathyroid adenomas and five parathyroid carcinomas in PHPT patients; and 18 parathyroid adenomas, 17 parathyroid hyperplasia lesions, and eight instances of nodular hyperplasia with adenoma in SHPT patients. The median volume of the lesions in PHPT and SHPT was 1.69 cm3 and 0.52 cm3 respectively, and the difference between them was statistically significant (P = 0.001). The median T/NT ratios calculated at the early phase of 99mTc-MIBI planar imaging, the delayed phase of 99mTc-MIBI planar imaging, and the subsequent SPECT/CT fusion imaging were 1.51, 1.34, and 2.75, respectively, in PHPT, and 1.46, 1.30, and 1.38, in SHPT, respectively. The T/NT ratio difference between PHPT and SHPT on the SPECT/CT fusion imaging was statistically significant (P = 0.002). The histopathology subtypes of the lesions were associated with significant differences in two areas: the T/NT ratios on the SPECT/CT fusion imaging and the volume of the lesions (P=0.002, P<0.001).ConclusionThe proportion of positive findings on 99mTc-MIBI dual-phase planar imaging and the T/NT ratios of 99mTc-MIBI SPECT/CT fusion imaging were higher in PHPT than in SHPT. The volume of parathyroid lesions in SHPT was smaller than in PHPT.

show abstract

Section: Discussionsupporting

confidence: 93%

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

Wang

Liu

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…Andrade et al noted that US and MIBI could not detect supernumerary PGs [15]. EI-Sageer et al recommended that neck exploration was the best reliable method for localization than imaging modalities [7]. However, from our experience, ectopic PGs in the thyroid, carotid sheath or mediastinum were di cult to detect during operation and the searching of neck prolonged the operative time.…”

Section: Discussionmentioning

confidence: 68%

“…Currently, the success of parathyroidectomy relies on localization with imaging and the experience of surgeon [6,7]. However, the incidence of surgical failure, de ned as persistent and recurrent SHPT after operation, is estimated to be 10-30%, largely due to incomplete localization.…”

Section: Introductionmentioning

confidence: 99%

Addressing the challenges of missed parathyroid glands in ultrasonography for secondary hyperparathyroidism.

Chou,

Yeh,

Chi

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Preoperative localization plays an important role in secondary hyperparathyroidism (SHPT) surgery. The advantages of neck ultrasound (US) include high availability and low cost. However, the reported sensitivity of US is 54–76%, and the reason for missed PG on US has been rarely addressed. Methods Fifty-four patients who were diagnosed with renal SHPT from September 2020 to March 2022 were included in this retrospective study. Preoperative localization included surgeon-oriented US and technetium 99m-sestamibi single-photon-emission-computed tomography/computed tomography (SPECT/CT). Results A total of 212 parathyroid glands (PGs) were pathologically confirmed, resulting in success rate of 96.2% (52/54). Using echo, 193 (91.0%) PGs were accurately localized, while 19 (9.0%) glands were not identified, including those in ectopic positions (n = 12, at thymus or intra-thyroid or others), of a small size (< 1 cm, n = 6), or overlapping with an ipsilateral PG (n = 1). US accurately detected four PGs in 36 (66.7%) patients, while SPECT/CT localized four glands in 19 (35.2%) patients. Although the number of US-detectable PGs was not associated with success rate, it showed significant negative correlation with surgical time (rs=-0.459, P = 0.002). Conclusion US detected four glands in 66% of SHPT patients with a sensitivity of 90% for localization. Ectopic position and small size were the most common reasons of failing to detect PG on US. Complete preoperative echo localization might shorten the operating time.

show abstract

Neck Exploration Versus Imaging Localization of Parathyroid in Secondary Hyperparathyroidism

Cited by 2 publications

References 17 publications

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

Comparison of biochemical markers and technetium 99m methoxyisobutylisonitrile imaging in primary and secondary hyperparathyroidism

Addressing the challenges of missed parathyroid glands in ultrasonography for secondary hyperparathyroidism.

Contact Info

Product

Resources

About