Predictors of accuracy in preoperative parathyroid adenoma localization using ultrasound and Tc-99m-Sestamibi: A 4-quadrant analysis

Management of a Parathyroid Adenoma With Radiofrequency Ablation: A Case Report

“…The most common cause of primary hyperparathyroidism is parathyroid adenoma (2). The complications of hyperparathyroidism include renal stones, osteoporosis, bone pain, and hypertension (3).…”

Radiographic evaluation of non-localizing parathyroid adenomas

“…Chapuis et al demonstrated a higher sensitivity for detection with US versus MIBI scans (92.5% vs. 80%) [12]. Cameron et al found similar results (63% vs. 41%) [13]. Combining these two imaging modality increases the sensitivity of localization to even greater than 90% as reported by Nasiri et al [14].…”

Highly specific preoperative selection of solitary parathyroid adenoma cases in primary hyperparathyroidism by quantitative image analysis of the early‐phase Technetium‐99m sestamibi scan

“…This significantly improved the test specificity to 90.0%, which was better than or comparable to the reported specificity of combined multiple imaging tests from published studies. 9,10,11,14,[16][17][18] According to ROC analysis, 23.9% of the total studies were rated as Class 3 and these scans highly specific for a single adenoma to recommend minimally invasive parathyroidectomy potentially based on Tc-99m sestamibi scan only.…”

“…Some groups had reported higher than 90% sensitivity of the Tc‐99m sestamibi scan for preoperative parathyroid adenoma localization with or without SPECT/CT, while others reported widely varying sensitivity of 41–86% . A number of technical and biological factors as well as the experience of the interpreting physician may affect the interpretation of the scan.…”

“…13 Some groups had reported higher than 90% sensitivity of the Tc-99m sestamibi scan for preoperative parathyroid adenoma localization with or without SPECT/CT, [14][15][16] while others reported widely varying sensitivity of 41-86%. 9,11,17,18 A number of technical and biological factors as well as the experience of the interpreting physician may affect the interpretation of the scan. Biological factors such as preoperative serum parathyroid hormone and calcium level, 19 tumour size and cellular oxyphil content 20 were reported as positive correlates for higher detection rates.…”