Giovanni Mariano Vitetta1, Alberto Ravera2, Giovanni Mensa2, Luca Fuso3, Pierluigi Neri4, Alessandro Carriero4, Stefano Cirillo5. 1. S.C. Radiodiagnostica, Azienda Ospedaliera Ordine Mauriziano di Torino, Largo Turati, 62-10128, Turin, Italy. gmvitetta@gmail.com. 2. S.S. Chirurgia della Tiroide, Azienda Ospedaliera Ordine Mauriziano di Torino, Turin, Italy. 3. Dipartimento di Scienze Chirurgiche, Università di Torino, Turin, Italy. 4. S.C.D.U. di Radiodiagnostica e Interventistica, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy. 5. S.C. Radiodiagnostica, Azienda Ospedaliera Ordine Mauriziano di Torino, Largo Turati, 62-10128, Turin, Italy.
Abstract
PURPOSE: Primary hyperparathyroidism (PHPT) is a frequent endocrine pathology that has surgical treatment as its only decisive measure. High-Resolution Neck Ultrasonography with color-Doppler (CDHR-NUS) and 99mTechnetium-SestaMIBI Parathyroid Scintigraphy (99mTc-MIBI PS) are the two instrumental exams more commonly used in the preoperatory localization of pathologic parathyroids. The aim of this observational study was to outline-in accordance with the latest scientific literature-the precise role of CDHR-NUS in the environment of PHPT, comparing it with that of Parathyroid Scintigraphy. METHODS: 136 patients operated on for PHPT and underwent CDHR-NUS and 99mTc-MIBI PS preoperatively. The CDHR-NUS was carried out by an expert medical sonographer. The results of the two methods were compared between each other and with the results of the operative act for the evaluation of accordance and diagnostic performances. RESULTS: PHPT is prevalently due to monoglandular pathology (SGD). The parallel use of CDHR-NUS and of 99mTc-MIBI PS does not determine a significant increase in diagnostic accuracy. The preoperative accordance evaluation between the two methods does not exclude the presence of multiglandular pathology (MGD) with certainty. CONCLUSIONS: CDHR-NUS is an accurate as well as cost-effective method; its role as a main and eventual unique preoperative localization method in patients affected by PHPT is confirmed. In the presence of expert medical sonographers, the sequential use of the two methods is retained correct and their use in parallel is neither justified nor cost-effective. The preoperative accordance evaluation between the two methods is neither necessary nor indispensable.
PURPOSE:Primary hyperparathyroidism (PHPT) is a frequent endocrine pathology that has surgical treatment as its only decisive measure. High-Resolution Neck Ultrasonography with color-Doppler (CDHR-NUS) and 99mTechnetium-SestaMIBI Parathyroid Scintigraphy (99mTc-MIBI PS) are the two instrumental exams more commonly used in the preoperatory localization of pathologic parathyroids. The aim of this observational study was to outline-in accordance with the latest scientific literature-the precise role of CDHR-NUS in the environment of PHPT, comparing it with that of Parathyroid Scintigraphy. METHODS: 136 patients operated on for PHPT and underwent CDHR-NUS and 99mTc-MIBI PS preoperatively. The CDHR-NUS was carried out by an expert medical sonographer. The results of the two methods were compared between each other and with the results of the operative act for the evaluation of accordance and diagnostic performances. RESULTS: PHPT is prevalently due to monoglandular pathology (SGD). The parallel use of CDHR-NUS and of 99mTc-MIBI PS does not determine a significant increase in diagnostic accuracy. The preoperative accordance evaluation between the two methods does not exclude the presence of multiglandular pathology (MGD) with certainty. CONCLUSIONS:CDHR-NUS is an accurate as well as cost-effective method; its role as a main and eventual unique preoperative localization method in patients affected by PHPT is confirmed. In the presence of expert medical sonographers, the sequential use of the two methods is retained correct and their use in parallel is neither justified nor cost-effective. The preoperative accordance evaluation between the two methods is neither necessary nor indispensable.
Authors: Michael A Morris; Babak Saboury; Mark Ahlman; Ashkan A Malayeri; Elizabeth C Jones; Clara C Chen; Corina Millo Journal: Front Endocrinol (Lausanne) Date: 2022-02-25 Impact factor: 5.555