Parathyroid adenoma screening efficacies of different imaging tools and factors affecting the success rates

Çakal, Erman; Çakır, Evrim; Dilli, Alper; Colak, Nujen; Ünsal, İlknur Öztürk; Aslan, Muyesser Sayki; Karbek, Başak; Özbek, Mustafa; Kılıç, Mehmet; Delibaşı, Tuncay; Şahi̇n, Mustafa

doi:10.1016/j.clinimag.2012.01.038

Cited by 11 publications

(18 citation statements)

References 27 publications

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“…This is surprisingly high, given the reported sensitivity of localising methods such as high-resolution ultrasonography, technetium (Tc) 99m-methoxyisobutylisonitrile parathyroid scintigraphy and magnetic resonance imaging. These three techniques correctly identified 90, 72 and 67% of adenomas, respectively, in a study of PHPT patients, and combining the methods improved sensitivity even further (12). It is possible that these specialised techniques were not readily available; alternatively, as mentioned above, patient selection criteria might have been a factor, or the physician might have had additional reasons for choosing cinacalcet for these patients that were not reported in the eCRF.…”

Section: Discussionmentioning

confidence: 99%

The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice

Schwarz

Body

et al. 2014

European Journal of Endocrinology

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Objective: Medical management of primary hyperparathyroidism (PHPT) is important in patients for whom surgery is inappropriate. We aimed to describe clinical profiles of adults with PHPT receiving cinacalcet. Design: A descriptive, prospective, observational study in hospital and specialist care centres. Methods: For patients with PHPT, aged 23-92 years, starting cinacalcet treatment for the first time, information was collected on dosing pattern, biochemistry and adverse drug reactions (ADRs). Initial cinacalcet dosage and subsequent dose changes were at the investigator's discretion. Results: Of 303 evaluable patients with PHPT, 134 (44%) had symptoms at diagnosis (mostly bone pain (58) or renal stones (50)). Mean albumin-corrected serum calcium (ACSC) at baseline was 11.4 mg/dl (2.9 mmol/l). The reasons for prescribing cinacalcet included: surgery deemed inappropriate (35%), patient declined surgery (28%) and surgery failed or contraindicated (22%). Mean cinacalcet dose was 43.9 mg/day (S.D., 15.8) at treatment start and 51.3 mg/day (31.8) at month 12; 219 (72%) patients completed 12 months treatment. The main reason for cinacalcet discontinuation was parathyroidectomy (40; 13%). At 3, 6 and 12 months from the start of treatment, 63, 69 and 71% of patients, respectively, had an ACSC of %10.3 mg/dl vs 9.9% at baseline. Reductions from baseline in ACSC of R1 mg/dl were seen in 56, 63 and 60% of patients respectively. ADRs were reported in 81 patients (27%), most commonly nausea. A total of 7.6% of patients discontinued cinacalcet due to ADRs. Conclusions: Reductions in calcium levels of R1 mg/dl was observed in 60% of patients 12 months after initiation of cinacalcet, without notable safety concerns.

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Section: Discussionmentioning

confidence: 99%

The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice

Schwarz

Body

et al. 2014

European Journal of Endocrinology

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“…Among these, USG and MIBI are two modalities most frequently used for preoperative localization of parathyroid adenomas providing high sensitivity and specificity [31,32,33,34,35]. USG alone is usually efficient enough to localize parathyroid adenoma preoperatively; MIBI is proposed to patients with nonlocalizing USG ( Figure 1) [36,37]. Besides, MIBI is more useful in localizing ectopic parathyroid adenomas, whereas USG -in intrathyroidal parathyroid adenomas [38].…”

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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“…[ 8 ] In their study, Cakal et al . [ 9 ] had shown that cervical US had a sensitivity of 89.7% and the TC-99 m-MIBI of 71.8%, and their combined use had a sensitivity of 92.3%. On the other hand, EAG Ibrahim et al .…”

Section: Discussionmentioning

confidence: 99%

“…reported that the diagnosis of a parathyroid adenoma was missed by cervical US in 25% of patients with thyroid pathology. [ 9 ] Most diagnostic studies reported the PPV of the test instead of specificity due to false-negative cases. In their meta-analysis, comparing 12 studies, Moghadam et al .…”

Section: Discussionmentioning

confidence: 99%

Primary Hyperparathyroidism

Salhi

Bouziane

Maâroufi

et al. 2022

Annals of African Medicine

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Introduction: The standard gold treatment of primary hyperparathyroidism (PHP) is parathyroidectomy. Imaging in particular, cervical ultrasound (US) and technetium-99 m- méthoxyisobutylisonitrileparathyroid scintigraphy using the single-photon emission computed tomography (TC-99 m-MIBI-SPECT) are always indicated prior to parathyroid surgery, allowing the location of parathyroid adenomas. The objective of our study is to evaluate the contribution of TC-99 m-MIBI-SPECT and US in the preoperative topographic diagnosis of PHP. Materials and Methods: this is a descriptive and analytical retrospective study, conducted in our department of Endocrinology, Diabetology and Metabolic Diseases in Hassan II University Hospital of Fez between 2009 and 2018. All patients who received a para-thyroidectomy for PHP were recruited. All patients had received a cervical US and a TC-99 m-MIBI-SPECT. We compared imaging data before surgery with data from intraoperative exploration and anatomopathological findings of surgical samples. Results: Forty-eight patients were collected. US correctly identified parathyroid adenoma in 85.40% of patients with PHP versus 89.50% in TC-99 m-MIBI-SPECT. US correctly predicted surgical outecomes in 97.60% of patients and TC-99 m-MIBI-SPECT in 97.72% of cases. Their combination had better results in sensitivity and positive predictive value. Conclusion: TC-99 m-MIBI-parathyroid scintigraphy SPECT had a higher probability for solitary parathyroid adenoma compared to cervical US. Its use coupled with the TC-99 m-MIBI-parathyroid scintigraphy SPECT allows reliable preoperative tracking.

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Parathyroid adenoma screening efficacies of different imaging tools and factors affecting the success rates

Cited by 11 publications

References 27 publications

The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice

The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice

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

Primary Hyperparathyroidism

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