Preoperative Localization of Parathyroid Lesion: Diagnostic Usefulness of Color Doppler Ultrasonography

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2012 Feb 14

PMID 22328952

Citations 7

Authors

Afshin Mohammadi

Farzad Moloudi

Mohammad Ghasemi-Rad

Affiliations

Soon will be listed here.

Abstract

Introduction: Recently, minimally invasive parathyroidectomy (MIP) has been developed and is gaining popularity among surgeons. For this reason, preoperative localization is playing an important role to detect the precise location of the affected gland and to increase the success rate.

Material And Methods: From June 2007 to June 2011, 56 consecutive patients (11 men and 45 women) with primary or secondary hyperparathyroidism in our center underwent Gray scale, color Doppler and 99m-Tc MIBI scan prior to operative management of parathyroid lesions.

Results: The sensitivity, specificity and accuracy of US and MIBI scan for pHPT was 88%, 94%, 91% and 70%, 100% and 85% respectively. In patients with sHPT, the sensitivity, specificity and accuracy of US and MIBI scan was 54%, 93%, 76% and 25%, 100% and 72.9% respectively. The overall sensitivity of combined US and MIBI scan in pHPT and sHPT was 97% and 45% respectively. The overall sensitivity, specificity and accuracy of CDUS in diagnosis of parathyroid lesions in pHPT and sHPT is 97%, 100%, 98.6% and 62%, 100% and 83% respectively.

Conclusion: The overall sensitivity and specificity of US and MIBI in preoperative localization of parathyroid adenoma in sHPT is lower than pHPT and performing CDUS can increases the overall sensitivity and specificity of imaging methods in accurate localization of parathyroid lesion.

Citing Articles

Addressing the challenges of missed parathyroid glands in ultrasonography for secondary hyperparathyroidism: a retrospective observational study.

Chou S, Yeh C, Chi S, Chou F, Wu Y, Chang Y Ann Surg Treat Res. 2024; 107(3):136-143.

PMID: 39282103 PMC: 11390283. DOI: 10.4174/astr.2024.107.3.136.

Clinical Characterization of Post-parathyroidectomy Patients with Primary Hyperparathyroidism and the Concordance of Preoperative Localization Imaging with Histopathology at a Tertiary Hospital in Manila, Philippines.

Francisco D, Paz-Pacheco E, Adorable-Wagan P J ASEAN Fed Endocr Soc. 2021; 35(1):77-84.

PMID: 33790496 PMC: 7992305. DOI: 10.15605/jafes.035.01.13.

Parathyroid Hormone Fragments: New Targets for the Diagnosis and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder.

Chen H, Han X, Cui Y, Ye Y, Purrunsing Y, Wang N Biomed Res Int. 2019; 2018:9619253.

PMID: 30627584 PMC: 6304519. DOI: 10.1155/2018/9619253.

The role of preoperative ultrasonography, computed tomography, and sestamibi scintigraphy localization in secondary hyperparathyroidism.

Lee J, Kim W, Lee Y Ann Surg Treat Res. 2015; 89(6):300-5.

PMID: 26665124 PMC: 4672093. DOI: 10.4174/astr.2015.89.6.300.

Ultrasonography alone can reliably locate parathyroid tumours and facilitates minimally invasive parathyroidectomy.

Butt H, Husainy M, Bolia A, London N Ann R Coll Surg Engl. 2015; 97(6):420-4.

PMID: 26274755 PMC: 5126235. DOI: 10.1308/003588415X14181254790202.

References

Kasai E, Da Silva J, Mandarim de Lacerda C, Boasquevisque E . Parathyroid glands: combination of sestamibi-(99m)Tc scintigraphy and ultrasonography for demonstration of hyperplasic parathyroid glands. Rev Esp Med Nucl. 2008; 27(1):8-12. DOI: 10.1157/13114364. View

Starker L, Fonseca A, Carling T, Udelsman R . Minimally invasive parathyroidectomy. Int J Endocrinol. 2011; 2011:206502. PMC: 3124248. DOI: 10.1155/2011/206502. View

Cecchin D, Motta R, Zucchetta P, Bui F, Basso S, Lumachi F . Imaging studies in hypercalcemia. Curr Med Chem. 2011; 18(23):3485-93. DOI: 10.2174/092986711796642607. View

Johnson N, Tublin M, Ogilvie J . Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. AJR Am J Roentgenol. 2007; 188(6):1706-15. DOI: 10.2214/AJR.06.0938. View

Saxe A, Lincenberg S, HAMBURGER S . Can the volume of abnormal parathyroid tissue be predicted by preoperative biochemical measurement?. Surgery. 1987; 102(5):840-5. View

Stawicki S, El Chaar M, Baillie D, Jaik N, Estrada F . Correlations between biochemical testing, pathology findings and preoperative sestamibi scans: a retrospective study of the minimally invasive radioguided parathyroidectomy (MIRP) approach. Nucl Med Rev Cent East Eur. 2008; 10(2):82-6. View

Sukan A, Reyhan M, Aydin M, Yapar A, Sert Y, Canpolat T . Preoperative evaluation of hyperparathyroidism: the role of dual-phase parathyroid scintigraphy and ultrasound imaging. Ann Nucl Med. 2008; 22(2):123-31. DOI: 10.1007/s12149-007-0086-z. View

Suh J, Cronan J, Monchik J . Primary hyperparathyroidism: is there an increased prevalence of renal stone disease?. AJR Am J Roentgenol. 2008; 191(3):908-11. DOI: 10.2214/AJR.07.3160. View

Mihai R, Wass J, Sadler G . Asymptomatic hyperparathyroidism--need for multicentre studies. Clin Endocrinol (Oxf). 2007; 68(2):155-64. DOI: 10.1111/j.1365-2265.2007.02970.x. View

10.

Tominaga Y . Surgical treatment of secondary hyperparathyroidism due to chronic kidney disease. Ups J Med Sci. 2007; 111(3):277-92. DOI: 10.3109/2000-1967-047. View

11.

De Feo M, Colagrande S, Biagini C, Tonarelli A, Bisi G, Vaggelli L . Parathyroid glands: combination of (99m)Tc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology. 2000; 214(2):393-402. DOI: 10.1148/radiology.214.2.r00fe04393. View

12.

Wermers R, Khosla S, Atkinson E, Achenbach S, Oberg A, Grant C . Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993-2001: an update on the changing epidemiology of the disease. J Bone Miner Res. 2005; 21(1):171-7. DOI: 10.1359/JBMR.050910. View

13.

Kakuta T, Tanaka R, Kanai G, Miyamoto Y, Inagaki M, Suzuki H . Relationship between the weight of parathyroid glands and their secretion of parathyroid hormone in hemodialysis patients with secondary hyperparathyroidism. Ther Apher Dial. 2008; 12(5):385-90. DOI: 10.1111/j.1744-9987.2008.00614.x. View

14.

Carpentier A, Jeannotte S, Verreault J, Lefebvre B, Bisson G, Mongeau C . Preoperative localization of parathyroid lesions in hyperparathyroidism: relationship between technetium-99m-MIBI uptake and oxyphil cell content. J Nucl Med. 1998; 39(8):1441-4. View

15.

Suter-Widmer I, Kraenzlin M, Meier C . [Primary hyperparathyroidism]. Ther Umsch. 2011; 68(6):321-6. DOI: 10.1024/0040-5930/a000172. View

16.

Simeone D, Sandelin K, Thompson N . Undescended superior parathyroid gland: a potential cause of failed cervical exploration for hyperparathyroidism. Surgery. 1995; 118(6):949-56. DOI: 10.1016/s0039-6060(05)80099-6. View

17.

Hung G, Wang S, Lin W . Tc-99m MIBI parathyroid scintigraphy and intact parathyroid hormone levels in hyperparathyroidism. Clin Nucl Med. 2003; 28(3):180-5. DOI: 10.1097/01.RLU.0000053529.71776.37. View

18.

Nguyen B . Parathyroid imaging with Tc-99m sestamibi planar and SPECT scintigraphy. Radiographics. 1999; 19(3):601-14; discussion 615-6. DOI: 10.1148/radiographics.19.3.g99ma10601. View

19.

Patel C, Scarsbrook A . Multimodality imaging in hyperparathyroidism. Postgrad Med J. 2009; 85(1009):597-605. DOI: 10.1136/pgmj.2008.077842. View

20.

Taniegra E . Hyperparathyroidism. Am Fam Physician. 2004; 69(2):333-9. View