TY - JOUR
T1 - Ultrasound for localization in primary hyperparathyroidism
AU - Smith, Russell B.
AU - Evasovich, Maria
AU - Girod, Douglas A.
AU - Jorgensen, Jeffrey B.
AU - Lydiatt, William M.
AU - Pagedar, Nitin A.
AU - Spanos, Willam C.
PY - 2013/9
Y1 - 2013/9
N2 - Objective. To evaluate the capability of ultrasound for preoperative localization in primary hyperparathyroidism. Study Design. Prospective study. Setting. Multi-institutional Midwest Head and Neck Cancer Consortium. Subjects and Methods. Two hundred twenty patients who underwent preoperative localization and had parathyroid surgery were evaluated. The findings of preoperative localization studies were correlated with surgical findings. Results. Preoperative ultrasonography, sestamibi scintigraphy, or both were obtained in 77%, 93%, and 69% of the patients, respectively. Preoperative ultrasonography and sestamibi scintigraphy localized an abnormality in 71% and 79% of patients, respectively. At the time of surgery, the localization by ultrasound was accurate in 82%. The accuracy of localization was similar for sestamibi scintigraphy (85%). In patients with inaccurate ultrasound localization, the sestamibi scintigraphy correctly identified the site of disease in only 45%. In patients with a nonlocalizing ultrasound, sestamibi scintigraphy was able to localize disease in only 47%, with 2 being in the mediastinum. Conclusions. Ultrasonography is an acceptable initial localization study for patients with primary hyperparathyroidism. In patients with nonlocalizing ultrasound, sestamibi scintigraphy should be obtained, but can be expected to detect an abnormality in less than 50% of patients.
AB - Objective. To evaluate the capability of ultrasound for preoperative localization in primary hyperparathyroidism. Study Design. Prospective study. Setting. Multi-institutional Midwest Head and Neck Cancer Consortium. Subjects and Methods. Two hundred twenty patients who underwent preoperative localization and had parathyroid surgery were evaluated. The findings of preoperative localization studies were correlated with surgical findings. Results. Preoperative ultrasonography, sestamibi scintigraphy, or both were obtained in 77%, 93%, and 69% of the patients, respectively. Preoperative ultrasonography and sestamibi scintigraphy localized an abnormality in 71% and 79% of patients, respectively. At the time of surgery, the localization by ultrasound was accurate in 82%. The accuracy of localization was similar for sestamibi scintigraphy (85%). In patients with inaccurate ultrasound localization, the sestamibi scintigraphy correctly identified the site of disease in only 45%. In patients with a nonlocalizing ultrasound, sestamibi scintigraphy was able to localize disease in only 47%, with 2 being in the mediastinum. Conclusions. Ultrasonography is an acceptable initial localization study for patients with primary hyperparathyroidism. In patients with nonlocalizing ultrasound, sestamibi scintigraphy should be obtained, but can be expected to detect an abnormality in less than 50% of patients.
KW - hyperparathyroidism
KW - localization
KW - ultrasonography
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U2 - 10.1177/0194599813491063
DO - 10.1177/0194599813491063
M3 - Article
C2 - 23748916
AN - SCOPUS:84884396518
SN - 0194-5998
VL - 149
SP - 366
EP - 371
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 3
ER -