Parathyroid adenoma screening efficacies of different imaging tools and factors affecting the success rates.

Abstract

PURPOSE:

We aimed to compare the efficacy of three different parathyroid adenoma screening tools--high-resolution ultrasonography (USG), technetium Tc 99m-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy, and magnetic resonance imaging (MRI)--and we evaluated the factors affecting the detection success rates.

METHODS:

Parathyroid imaging was evaluated by USG, double-phase 99mTc-MIBI parathyroid scintigraphy, and cervical MRI in patients with hyperparathyroidism (n=39).

RESULTS:

Among the 39 patients, USG, parathyroid scintigraphy, and MRI correctly identified 35 adenomas (89.7%), 28 adenomas (71.8%), and 26 adenomas (66.7%), respectively. Positive predictive values for USG (34/35), scintigraphy (27/28), and cervical MR (26/26) imaging were 97.1%, 96%, and 100%, respectively. Parathyroid adenomas were detected with 92.3% (36/39) certainty when both USG and scintigraphy modalities were applied together. Minimally invasive parathyroidectomy under local anesthesia with unilateral incision was successfully performed in 24 (61.5%) patients.

CONCLUSIONS:

Minimally invasive surgery for parathyroid adenomas has been developed and has equal success with traditional surgery. However, accurate localization of adenomas should be obtained prior to surgery. In this study, ultrasound was found to be effective in localizing adenomas for successful surgery. Adding other imaging modalities does not improve localizing the parathyroid adenomas.

• Authors: Erman Cakal, Evrim Cakir, Alper Dilli, Nujen Colak, Ilknur Unsal, Müyesser Sayki Aslan, Basak Karbek, Mustafa Ozbek, Mehmet Kilic, Tuncay Delibasi, Mustafa Sahin
• Journal: Clinical imaging (Clin Imaging) 2012 Nov-Dec Vol. 36 Issue 6 Pg. 688-94 ISSN: 1873-4499 [Electronic] United States
• PMID: 23153996 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Sestamibi

Topics

• Adenoma (diagnosis)
• Female
• Humans
• Magnetic Resonance Imaging (methods)
• Male
• Mass Screening (methods)
• Parathyroid Neoplasms (diagnosis)
• Positron-Emission Tomography (methods)
• Preoperative Care (methods)
• Prognosis
• Radiopharmaceuticals
• Reproducibility of Results
• Sensitivity and Specificity
• Technetium Tc 99m Sestamibi
• Ultrasonography (methods)