Preoperative localization of parathyroid adenomas

Attie, Joseph N.; Khan, A.N.; Rumancik, William M.; Moskowitz, Gerard W.; Hirsch, Martin A.; Herman, Peter C.

doi:10.1016/s0002-9610(88)80304-0

Cited by 39 publications

(15 citation statements)

References 6 publications

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“…With experience, some surgeons claim a success rate of 90%-95%, arguing that unnecessary costs and increased time are disadvantages of image localisation methods. Furthermore, the false-negative rate, in particular, inevitably means that bilateral neck exploFerlin et al [ [10][11][12][13]. Conversely, some authors insist that pre-operative localisation does serve a useful purpose, by limiting the exploration, reducing operation time and decreasing the complication rate [10,[14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Thallium-technetium-subtraction scintigraphy in secondary hyperparathyroidism

et al. 1994

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Between 1983 and 1992 thallium-technetium subtraction scintigraphy (TTS) was performed on 74 patients with clinical and biochemical evidence of hyperparathyroidism. Twenty-five of the 53 investigations since 1988 were conducted on patients with renal failure with a suspicion of secondary hyperparathyroidism. In a retrospective study we have evaluated radioisotope scintigraphy for patients with adenoma and for renal failure patients with possible parathyroid hyperplasia. Thirty of 74 patients underwent neck exploration. Scintigraphy detected 17 of 24 parathyroid adenomas (sensitivity 71%). In contrast, in six renal patients who came to operation, scintigraphy localised only 5 of 20 hyperplastic parathyroid glands (sensitivity 25%) and in one renal patient we localised a parathyroid adenoma. A review of the literature shows low detection rates for hyperplasia by TTS to be a common observation. Based on these findings a rational approach is offered for parathyroid localisation in renal patients prior to neck exploration.

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Section: Discussionmentioning

confidence: 99%

Thallium-technetium-subtraction scintigraphy in secondary hyperparathyroidism

et al. 1994

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“…The sensitivity of ultrasound for the parathyroid adenoma localization in primary HPT ranges between 70 and 80 % [1,41,42,43]. Specificity may be improved with ultrasound using FNAB.…”

Section: Parathyroid Glandsmentioning

confidence: 99%

Ultrasound of thyroid, parathyroid glands and neck lymph nodes

Solbiati

Osti²,

Cova³

et al. 2001

Eur Radiol

215

133

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In the past 15 years high-frequency B-mode sonography and colour-power Doppler have become the most important and most widely employed imaging modalities for the study of the neck, in particular for thyroid gland, parathyroids and lymph nodes. Sonography allows not only the detection but often also the characterization of the diseases of these organs, distinguishing benign from malignant lesions with high sensitivity and specificity, which could be further improved by the employ of ultrasound contrast agents and harmonic imaging. Although no single sonographic criterion is specific for benign or malignant nature of the lesions, the combination of different signs can be markedly helpful to speed up the diagnostic process. Fine-needle aspiration biopsy (FNAB) remains the most accurate modality for the definitive assessment of thyroid gland nodules and of any doubtful case of nodal disease. In association with clinical findings and serum levels of parathormone, FNAB has specificity close to 100% for the characterization of parathyroid adenomas. A combined approach with sonography and FNAB is generally highly effective.

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“…The ability of USG to detect enlarged parathyroid glands ranges from 34% to 92%. [5][6][7] This variable accuracy of USG for preoperative localization of enlarged parathyroid glands is due to its high operator dependence, his experience, skill and other factors like weight of the enlarged gland. Higher the weight of gland easily it will be picked up by USG.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently many studies have shown the efficacy of high resolution USG with varying results of sensitivity ranging from 34% to 92% with a false positive rate of 4% to 25%. [5][6][7] Among the above modalities of diagnosis of abnormally functioning parathyroid glands high resolution USG has the advantage of easily availability, affordability and patient convenience. 8 In 1989 99mTc-MIBI Scan was introduced as a modality for diagnosing abnormally functioning parathyroid glands9.…”

Section: Introductionmentioning

confidence: 99%

Prospective comparison of high resolution ultrasonography with technetium sestamibi scintigraphy and operative findings in detection of abnormally hyper functioning parathyroid gland/glands in primary hyperparathyroidism

Dar

Wani

et al. 2016

Int Surg J

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Background:Ultrasonography is cheap, easily available and convenient modality of diagnosis.Methods: We prospectively studied 61 patients with PHPT. Patients preoperatively underwent USG neck and MIBI scan, results were interpreted independently and compaired with intra operative findings.Results:61 patients who underwent parathyroidectomy for PHPT were studied. Ultrasonography neck showed correct side in 46/51 (90%) and correct site in 32/51 (63%) patients with single parathyroid adenomas. MIBI scan showed correct side and site of parathyroid adenoma in 46/50 (92%) and 43/50 (86%) patients respectively. Patients with double adenomas USG neck showed positive results in all 5 patient with 100% sensitivity where as MIBI scan showed positive results in four out of five patients (80%). 1 patient with four gland hyperplasia USG picked three out of four enlarged glands while as MIBI scan not picked any of the enlarged glands. Operative findings revealed that right lower parathyroid gland was the most common gland involved (54%) followed by left lower (29%), right upper (6.6%), left upper (0%) and multiple / bilateral (9.6%).Conclusions:USG is an affordable, conventional and useful tool in detecting enlarged parathyroid glands in most of the patients with PHPT, but operator dependant. However, when USG can’t detect enlarged parathyroid gland 99mTc-MIBI Scan is complimentary to it.

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Preoperative localization of parathyroid adenomas

Cited by 39 publications

References 6 publications

Thallium-technetium-subtraction scintigraphy in secondary hyperparathyroidism

Thallium-technetium-subtraction scintigraphy in secondary hyperparathyroidism

Ultrasound of thyroid, parathyroid glands and neck lymph nodes

Prospective comparison of high resolution ultrasonography with technetium sestamibi scintigraphy and operative findings in detection of abnormally hyper functioning parathyroid gland/glands in primary hyperparathyroidism

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