Can ultrasound be used as the primary screening modality for the localization of parathyroid disease prior to surgery for primary hyperparathyroidism? A review of 440 cases

Joshua M. Levy, Emad Kandil, Lillian C. Yau, Jonathan D. Cuda, Sheila N. Sheth, Ralph P. Tufano

Research output: Contribution to journalArticle

Abstract

Background/Aims: Sestamibi scintigraphy and neck ultrasonography have both been proposed as screening modalities for the detection of abnormal parathyroid glands in patients with primary hyperparathyroidism. As a result, many surgeons use both techniques prior to surgery. The goal of this study was to independently evaluate both ultrasound and sestamibi as single-modality preoperative screening tools for primary hyperparathyroidism. Methods: A retrospective review of consecutive patients who underwent surgery for primary hyperparathyroidism from January 1999 to December 2009. Imaging results were compared to surgical findings. Results: 440 patients were found to meet inclusion criteria. Sensitivities for correct localization of a single parathyroid adenoma for sestamibi versus ultrasound were: 83% (95% CI 78-86) versus 72% (95% CI 67-76). Ultrasound operator had no influence on sensitivity, and ultrasound identified nodular thyroid disease in 31% of patients. Conclusion: Ultrasonography alone can be used as the primary screening modality in patients with primary hyperparathyroidism. Ultrasound sensitivity is conserved despite operator variability, and identifies concomitant thyroid pathology.

Original languageEnglish (US)
Pages (from-to)116-120
Number of pages5
JournalORL
Volume73
Issue number2
DOIs
StatePublished - Mar 1 2011

Keywords

  • Parathyroid disease
  • Primary hyperparathyroidism
  • Ultrasound

ASJC Scopus subject areas

  • Otorhinolaryngology

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