Diagnostic value of endoscopic ultrasonography for preoperative localization of parathyroid adenomas

Background. Endoscopic ultrasonography (EUS) is the first imaging modality for investigating the depth of invasion in early gastric cancer (EGC). However, there is presently no consensus on the accuracy of EUS in diagnosing the invasion depth of EGC. Aim. This study is aimed at systematically evaluating the accuracy of EUS in diagnosing the invasion depth of EGC and its affecting factors. Methods. The literatures were identified by searching PubMed, SpringerLink, Cochrane Library, Web of Science, Nature, and Karger knowledge databases. Two researchers extracted the data from the literature and reconstructed these in 2×2 tables. The Meta-DiSc software was used to evaluate the overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic advantage ratio, and 95% confidence interval (CI). The SROC was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value. Results. A total of 17 articles were selected, which included 4525 cases of lesions. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic dominance ratio, and 95% CI of EUS for diagnosing EGC was 0.87 (95% CI: 0.86-0.88), 0.67 (95% CI: 0.65-0.70), 2.90 (95% CI: 2.25-3.75), 0.17 (95% CI: 0.13-0.23), and 18.25 (95% CI: 12.61-26.39), respectively. The overall overstaging rate of mucosa/submucosa 1 (M/SM1) and SM by EUS was 13.31% and 32.8%, respectively, while the overall understaging rate of SM was 29.7%. The total misdiagnosis rates for EUS were as follows: 30.4% for lesions≥2 cm and 20.9% for lesions<2 cm, 27.7% for ulcerative lesions and 21.4% for nonulcerative lesions, and 22% for differentiated lesions and 26.9% for undifferentiated lesions. Conclusion. EUS has a moderate diagnostic value for the depth of invasion of EGC. The shape, size, and differentiation of lesions might be the main factors that affect the accuracy of EUS in diagnosing EGC.

Download Full-text

Diagnostic value of endoscopic ultrasonography in detection of gastrointestinal protuberant lesions and reasons for misdiagnosis

World Chinese Journal of Digestology ◽

10.11569/wcjd.v22.i11.1552 ◽

2014 ◽

Vol 22 (11) ◽

pp. 1552

Author(s):

Ming-Kai Chen ◽

Yun-Yan Liu ◽

Bai-Jing Ding ◽

Sheng Li ◽

Min Dai ◽

...

Keyword(s):

Endoscopic Ultrasonography ◽

Diagnostic Value

Download Full-text

Thyroid-Related Factors that Influence Preoperative Localization of Parathyroid Adenomas

Endocrine Practice ◽

10.4158/ep11089.or ◽

2012 ◽

Vol 18 (1) ◽

pp. 26-33 ◽

Cited By ~ 5

Author(s):

Serhat Isik ◽

Gulhan Akbaba ◽

Dilek Berker ◽

Yasemin Tutuncu ◽

Ufuk Ozuguz ◽

...

Keyword(s):

Preoperative Localization ◽

Related Factors ◽

Parathyroid Adenomas

Download Full-text

Interobserver Reliability of Endoscopic Ultrasonography: Literature Review

Diagnostics ◽

10.3390/diagnostics10110953 ◽

2020 ◽

Vol 10 (11) ◽

pp. 953

Author(s):

Akira Yamamiya ◽

Atsushi Irisawa ◽

Ken Kashima ◽

Yasuhito Kunogi ◽

Kazunori Nagashima ◽

...

Keyword(s):

Chronic Pancreatitis ◽

Diagnostic Criteria ◽

Endoscopic Ultrasonography ◽

Interobserver Reliability ◽

Image Interpretation ◽

Diagnostic Value ◽

Cystic Mass ◽

Diagnostic Characteristics ◽

Digestive Disorders ◽

Subepithelial Lesions

Endoscopic ultrasonography (EUS) has been applied to the diagnosis of various digestive disorders. Although it has been widely accepted and its diagnostic value is high, the dependence of EUS diagnosis on image interpretation done by the endosonographer has persisted as an important difficulty. Consequently, high interobserver reliability (IOR) in EUS diagnosis is important to demonstrate the reliability of EUS diagnosis. We reviewed the literature on the IOR of EUS diagnosis for various diseases such as chronic pancreatitis, pancreatic solid/cystic mass, lymphadenopathy, and gastrointestinal and subepithelial lesions. The IOR of EUS diagnosis differs depending on the disease; moreover, EUS findings with high IOR and those with IOR that was not necessarily high were used as diagnostic criteria. Therefore, to further increase the value of EUS diagnosis, EUS diagnostic criteria with high diagnostic characteristics based on EUS findings with high IOR must be established.

Download Full-text

Accurate Preoperative Localization of Parathyroid Adenomas With C-11 Methionine PET/CT

Annals of Surgery ◽

10.1097/sla.0b013e318289b345 ◽

2013 ◽

Vol 257 (6) ◽

pp. 1124-1128 ◽

Cited By ~ 30

Author(s):

Theresia Weber ◽

Clemens Maier-Funk ◽

Dagmar Ohlhauser ◽

Andreas Hillenbrand ◽

Gregor Cammerer ◽

...

Keyword(s):

Preoperative Localization ◽

Pet Ct ◽

Parathyroid Adenomas

Download Full-text

Preoperative Localization of Parathyroid Adenomas Using99mTc-MIBI Scintigraphy in Patients with Hyperparathyroidism

International Journal of Urology ◽

10.1111/j.1442-2042.1997.tb00157.x ◽

1997 ◽

Vol 4 (2) ◽

pp. 126-129 ◽

Cited By ~ 1

Author(s):

Shoichi Ebisuno ◽

Takeshi Inagaki ◽

Toshihiko Yoshida ◽

Motoki Yamamoto ◽

Yoji Tabuse ◽

...

Keyword(s):

Preoperative Localization ◽

Parathyroid Adenomas ◽

Mibi Scintigraphy

Download Full-text

SPECT/CT’s Advantage for Preoperative Localization of Small Parathyroid Adenomas in Primary Hyperparathyroidism

Clinical Nuclear Medicine ◽

10.1097/rlu.0000000000001447 ◽

2017 ◽

Vol 42 (2) ◽

pp. e109-e114 ◽

Cited By ~ 20

Author(s):

Patricia Sandqvist ◽

Inga-Lena Nilsson ◽

Per Grybäck ◽

Alejandro Sanchez-Crespo ◽

Anders Sundin

Keyword(s):

Primary Hyperparathyroidism ◽

Preoperative Localization ◽

Parathyroid Adenomas

Download Full-text

Value of Ultrasonography, CT and MR Imaging in the Diagnosis of Primary Hyperparathyroidism

Acta Radiologica ◽

10.1177/02841851960373p260 ◽

1996 ◽

Vol 37 (3P2) ◽

pp. 720-726 ◽

Cited By ~ 7

Author(s):

C. Tziakouri ◽

E. Eracleous ◽

S. Skannavis ◽

A. Pierides ◽

P. Symeonides ◽

...

Keyword(s):

Mr Imaging ◽

Primary Hyperparathyroidism ◽

Detection Rate ◽

Cost Effective ◽

Clinical Results ◽

Parathyroid Glands ◽

Preoperative Localization ◽

Confirmatory Test ◽

Parathyroid Adenomas ◽

Ectopic Parathyroid

Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. Combination of all 3 studies, however, alerted the physician to the presence of disease in more than one gland in 87% of these patients. Conclusion: US, CT and MR imaging followed by surgery performed by an experienced surgeon provided good clinical results in 39 patients with primary hyperparathyroidism. Preoperative localization was especially useful in patients with primary parathyroid hyperplasia or multiple adenomas and in patients with ectopic parathyroid adenomas in the root of the neck. We recommend identification of all abnormal parathyroid glands prior to surgery.

Download Full-text