Sensitivity of localization studies performed by various radiologists in the evaluation of parathyroid lesions

Year 2018, Volume: 4 Issue: 2, 112 - 117, 04.04.2018

Pınar Şişman , Özen Öz Gül Soner Cander , Ahmet Bilgehan Şahin , Çoşkun Demirtaş Aybüke Muti Onur Elbasan Özlem Saraydaroğlu Erdinç Ertürk

https://doi.org/10.18621/eurj.308830

Abstract

Objectives. Preoperative imaging studies are commonly used in the
diagnosis of primary hyperparathyroidism to increase the success rate of
surgery. In the present study, we aimed to correlate surgical outcomes with the
sensitivity of localization studies that were performed by various radiologists. Methods. One
hundred eighty-nine patients with preoperative diagnosis primary hyperparathyroidism
were included. A total of 174 patients in whom hypercalcemia had been cured by
parathyroidectomy, were evaluated retrospectively. In total, 184 lesions were
excised from these 174 patients. Ultrasonography (USG) and technetium-99m-methoxy isobutyl isonitrile (^99mTc-MIBI) imaging
yielded correctly localized lesion in 74 and 108 patients, respectively. Results.
The specificity of USG and ^99mTc-MIBI imaging were similar (95.9%
and 95.0%, respectively). However, the sensitivity was not satisfactory (45.9%
for USG, 62.4% for ^99mTc-MIBI). The gland size was not significant
for the rate of lesion detection by ^99mTc-MIBI scan or USG.
Significant differences were not observed between the preoperative serum
parathormone, serum calcium or 24-hour urine calcium excretion levels and the
success rate of localization with either USG or ^99mTc-MIBI. Conclusions.
Radiologist experience in ultrasonographic parathyroid imaging was found to
affect sensitivity. Therefore, surgeons, radiologists and endocrinologists that
perform ultrasonographic evaluation should have extensive experience. 

Keywords

primary hyperparathyroidism, parathyroidectomy, localization studies, ultrasonography, technetium-99m-methoxy isobutyl isonitrile

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