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The Detection of Preoperative Parathyroid Lesions: The Success of Ultrasonography, Technetium-99m Methoxyisobutylisonitrile Parathyroid Scintigraphy, and Single-Photon Emission Computed Tomography-Computed Tomography.
- Source :
-
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2021 Dec; Vol. 27 (12), pp. 1193-1198. Date of Electronic Publication: 2021 Jul 20. - Publication Year :
- 2021
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Abstract
- Objective: We aimed to find and compare the efficacy of ultrasonography (US), technetium-99m methoxyisobutylisonitrile parathyroid scintigraphy (MIBI-S), and single-photon emission computed tomography-computed tomography (SPECT-CT) in detecting the localization of parathyroid adenomas in patients with primary hyperparathyroidism.<br />Methods: In total, 348 patients were included in this study. Preoperative parathyroid imaging with US, MIBI-S, and SPECT-CT was evaluated and compared with operative findings. The results of the imaging methods were compared with pathology and operation reports.<br />Results: In 318 patients (91.3%), one of the imaging methods was able to localize the lesion correctly. US detected the localization of the parathyroid lesions correctly in 268 patients (77%), whereas SPECT-CT and MIBI-S were correct in 254 (73%) and 209 (60%) patients, respectively. There was a statistically significant relationship between the parathyroid hormone (PTH) level and 3 imaging methods' success rates (P < .05). The PTH cut-off value, which best determined the correct localization, was 152.5 pg/mL for US, 143 pg/mL for MIBI-S, and 143 pg/mL for SPECT-CT. It was observed that the correct localization rate for parathyroid lesions increased with higher PTH levels.<br />Conclusion: In our study population, US was more successful, in most cases, than other imaging methods in localizing parathyroid lesions but SPECT-CT was more accurate in localizing mediastinal lesions. In addition, it was found that preoperative PTH levels affect the accuracy of imaging methods.<br /> (Copyright © 2021 AACE. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Parathyroid Glands diagnostic imaging
Parathyroid Glands surgery
Radionuclide Imaging
Radiopharmaceuticals
Sensitivity and Specificity
Single Photon Emission Computed Tomography Computed Tomography
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed, Single-Photon
Ultrasonography
Hyperparathyroidism, Primary diagnostic imaging
Hyperparathyroidism, Primary surgery
Technetium
Subjects
Details
- Language :
- English
- ISSN :
- 1530-891X
- Volume :
- 27
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
- Publication Type :
- Academic Journal
- Accession number :
- 34298158
- Full Text :
- https://doi.org/10.1016/j.eprac.2021.07.010