Optimizing preoperative imaging in primary hyperparathyroidism
- 23 August 2006
- journal article
- clinical trial
- Published by Springer Nature in Langenbecks Archives Of Surgery
- Vol. 391 (6) , 551-556
- https://doi.org/10.1007/s00423-006-0076-y
Abstract
Scintigraphy of the hyperfunctioning parathyroid glands using technetium 99m (99mTc)-methoxyisobutylisonitrile (99mTc-MIBI) is an established and highly sensitive preoperative localization tool whose importance has been further increased by advances in minimally invasive surgery .The goal of the present prospective study was to determine the benefit of optimized imaging in a consistent patient population. Eighty-four patients with first presentations of primary hyperparathyroidism were investigated with 99mTc-MIBI scintigraphy, thyroid scintigraphy, and cervical ultrasonography. The evaluation algorithm consisted of (a) evaluation of the planar images alone, (b) additional evaluation of single-photon emission computed tomography (SPECT), (c) additional evaluation of thyroid gland scintigraphy, and (d) additional evaluation of ultrasound. All patients subsequently underwent parathyroidectomy. The intraoperative and the histologic findings were correlated with the results of the scintigraphic imaging. The sensitivity of planar parathyroid scintigraphy was 74% and could be increased to 91% by the additional investigations. The difference was statistically significant (p99mTc-MIBI scintigraphy, additional SPECT plus thyroid gland scintigraphy, plus high-resolution cervical ultrasonography.Keywords
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