Evaluation of the Radiological Findings of the Patints Having Surgical Intervention For The Primary Hyperparathyroidism

Surgical Intervention ◽

Demographic Data ◽

Diagnostic Sensitivity ◽

Histopathological Diagnosis ◽

Dual Phase ◽

Diagnostic Sensitivity And Specificity

Diagnostic Significance ◽

Parathyroid Adenomas ◽

Objective: In this study, we aimed to compare the results of ultrasonography and Tc-99m sestamibi dual phase parathyroid scintigraphy with postoperative pathology findings in patients with primary hyperparathyroidism. Methods: The study was carried out with 96 patients, who had surgical intervention for primary hyperparathyroidism and followed up in the Endocrinology and Metabolism Clinic, between January 2010-December 2015. Demographic data and preoperative laboratory results of the patients were reviewed. Diagnostic accuracy and compliance were calculated by comparing imaging methods with surgical localization and histopathological evaluation results. Results: Parathyroid adenomas were detected in 75, parathyroid hyperplasia in 12, and parathyroid carcinoma in 5 and suspect pathology results in 4 patients. The mean preoperative calcium (11.25 mg/dl) and parathormone (400.06 pg/ml) levels were determined. Ultrasonography had an estimated diagnostic sensitivity of 58.7% and a specificity of 38.5% in cases with parathyroid adenoma. It was observed that ultrasonography has not any diagnostic significance, and it is not in accordance with histopathological diagnosis (Kappa=-0.018, p=0.851). Diagnostic sensitivity, and specificity of scintigraphy were found to be 58.7%, and 38.5%, respectively. It was observed to be only fairly concordant, and significant according to histopathological diagnosis (Kappa=0.221, p=0.047). Conclusion: Tc-99m MIBI dual-phase parathyroid scintigraphy, a highly sensitive and noninvasive imaging technique, is clearly superior to the ultrasonography in detecting parathyroid adenomas and locating regions correctly.

PRE-OPERATIVE LOCALIZATION OF HYPERFUNCTIONING PARATHYROID TISSUE BY PARATHYROID SCINTIGRAPHY

Acta Endocrinologica ◽

10.1530/acta.0.0810298 ◽

1976 ◽

Vol 81 (2) ◽

pp. 298-309 ◽

Cited By ~ 4

Author(s):

P. Burckhardt ◽

A. Bischof-Delaloye ◽

B. Ruedi ◽

B. Delaloye

Keyword(s):

False Positive ◽

Parathyroid Tissue ◽

Tubular Reabsorption ◽

Plasma Calcium ◽

Biochemical Screening ◽

Parathyroid Adenomas ◽

Positive Results ◽

Positive Focus

ABSTRACT In 22 patients who underwent surgery suspected of primary hyperparathyroidism, the surgical findings were compared with the results obtained by pre-operative parathyroid scanning and biochemical screening. Thirteen of 15 parathyroid adenomas were localized by pre-operative scanning, but in five of them a false positive focus was also described. The technique was less useful in primary hyperplasia. Comparable results were reported by other investigators. In both instances the best results were obtained in patients with high parathyroid activity as measured by plasma calcium, plasma alkaline phosphatase and tubular reabsorption of phosphorus (TRP). Parathyroid scintigraphy was especially helpful in the presence of ectopic adenomas and in patients who had undergone previous parathyroid surgery. Unfortunately, the possibility of false positive results makes it unreliable for the diagnosis of primary hyperparathyroidism.

Diagnostic Significance of Clinicopathological Concordance in Various Spectrums of Skin Disorders

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i1.29633 ◽

2020 ◽

Vol 5 (1) ◽

pp. 955-959

Author(s):

Santosh Upadhyaya Kafle ◽

Dilip Chaudhary ◽

Sabrina Yamu Sabrina Yamu ◽

Krishna Jha

Keyword(s):

Skin Diseases ◽

Demographic Data ◽

Age Groups ◽

Female Gender ◽

Histopathological Diagnosis ◽

Skin Disorders ◽

Disease Category ◽

Diagnostic Significance ◽

Cross Sectional ◽

Skin Biopsies

Introduction: Wide spectrums of skin disorders exist in the world. Skin biopsy is a proven method for allying the dermatologist in overcoming the diagnostic dilemmas that occur in consultations. The different level of clinicopathological concordance, either full or partial and discordant study may reflect the agreement between the clinicians and pathologists for diagnosing spectrum of skin disorders. Objectives: To analyze the histopathological spectrum of skin diseases emphasizing on the diagnostic significance of its clinicopathological concordance. Methodology: This is a prospective cross sectional hospital based study of skin biopsies obtained in the Department of Pathology, at Birat Medical College and Teaching Hospital from Dec 2016 to Jan 2020. Demographic data, nature of lesions, correlation between clinicopathological concordance and histopathological diagnosis were analyzed using SPSS version 16. Result: Among 111 skin biopsies, female gender of 19-39 years age groups was predominant. The commonest histopathological diagnosis of skin biopsies was under infectious and bacterial origin category (24.3%) reflecting non-neoplastic nature mostly. The overall clinicopathological concordant was 78.38% (fully concordant 27.93% and partially concordant 50.45%) and discordant 21.62%. Nature of lesions was strongly correlated (p<0.05) with age group, while it was weak with gender. However, the relationship was very strong between histopathological diagnosis and clinicopathological concordance (p<0.05%). Conclusion: Findings suggest that the clinicopathological concordance correlated well in histopathologically diagnosed disease category of skin disorders. This reflects the high diagnostic value of histopathological examinations for diagnosing different spectrum of skin disorders.

Correlation between serum calcium levels and dual-phase 99mTc-sestamibi parathyroid scintigraphy in primary hyperparathyroidism

Clinical Physiology and Functional Imaging ◽

10.1111/j.1475-097x.2011.01048.x ◽

2011 ◽

Vol 32 (1) ◽

pp. 19-24 ◽

Cited By ~ 10

Author(s):

D. S. Mshelia ◽

A. N. Hatutale ◽

N. P. Mokgoro ◽

M. E. Nchabaleng ◽

J. R. Buscombe ◽

...

Keyword(s):

Serum Calcium ◽

Dual Phase ◽

99Mtc Sestamibi

Differential Findings of Tc-99m Sestamibi Dual-Phase Parathyroid Scintigraphy Between Benign and Malignant Parathyroid Lesions in Patients with Primary Hyperparathyroidism

Nuclear Medicine and Molecular Imaging ◽

10.1007/s13139-011-0103-y ◽

2011 ◽

Vol 45 (4) ◽

pp. 276-284 ◽

Cited By ~ 3

Author(s):

Miju Cheon ◽

Joon Young Choi ◽

Jae-Hoon Chung ◽

Ji Young Lee ◽

Sook Kyung Cho ◽

...

Keyword(s):

Dual Phase ◽

Parathyroid Lesions

Accuracy of Dual Phase Single-Photon Emission Computed Tomography/Computed Tomography in Primary Hyperparathyroidism: Correlation with Serum Parathyroid Hormone Levels

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2015.06.002 ◽

2016 ◽

Vol 67 (2) ◽

pp. 115-121 ◽

Cited By ~ 4

Author(s):

Wade Koberstein ◽

Christopher Fung ◽

Kristy Romaniuk ◽

Jonathan T. Abele

Keyword(s):

Computed Tomography ◽

Predictive Value ◽

Single Photon ◽

Photon Emission ◽

Emission Computed Tomography ◽

Dual Phase ◽

Parathyroid Adenomas ◽

Ectopic Parathyroid ◽

Serum Pth

Purpose The objectives of this study were: 1) to determine the accuracy of dual-phase 99mTc -methoxyisobutylisonitrile (MIBI) with single-photon emission computed tomography/computed tomography (SPECT/CT) for the preoperative localization of parathyroid adenomas in the setting of primary hyperparathyroidism; 2) to determine the accuracy of localization for ectopic glands; and 3) to assess the relationship between accuracy and serum parathyroid hormone (PTH) levels. Methods Eighty-eight patients who underwent 99mTc-MIBI SPECT/CT imaging for primary hyperparathyroidism at our institution over a 27-month period were retrospectively assessed. The preoperative SPECT/CT results were compared to intraoperative findings (within 1 year of imaging). The relationship between serum PTH level (within 3 months) and SPECT/CT accuracy was then evaluated. Results Accuracy indices for the retrothyroid subgroup were sensitivity 86.7%, specificity 96.4%, positive predictive value 98.1%, negative predictive value 77.1%, and accuracy 89.8%. Accuracy indices for ectopic parathyroid adenomas were sensitivity 81.5%, specificity 100%, positive predictive value 100%, negative predictive value 92.4%, and accuracy 94.3%. For the overall group, SPECT/CT demonstrated a sensitivity of 85.1% and a PPV of 98.7%. SPECT/CT correctly identified the abnormal parathyroid gland in 60% of patients with a normal serum PTH (<6.9 pmol/L), 73% between 6.9-9.9 pmol/L, 86% between 10.0-14.9 pmol/L, 100% between 15.0-19.9 pmol/L, 88% between 20.0-24.5 pmol/L, and 100% of patients with a PTH greater than 25.0 pmol/L. Conclusions Dual-phase 99mTc- MIBI with SPECT/CT is an accurate and reliable means to correctly localize both retrothyroid and ectopic parathyroid adenomas for the purpose of surgical planning. The accuracy of SPECT/CT increases with increasing serum PTH levels.

Preoperative localization of suspicious parathyroid adenomas by assay of parathyroid hormone in needle aspirates

Acta Endocrinologica ◽

10.1530/eje.0.1390072 ◽

1998 ◽

pp. 72-77 ◽

Cited By ~ 47

Author(s):

C Marcocci ◽

S Mazzeo ◽

G Bruno-Bossio ◽

A Picone ◽

E Vignali ◽

...

Keyword(s):

Parathyroid Hormone ◽

Parathyroid Adenoma ◽

Nodular Goiter ◽

Neck Mass ◽

Simple Method ◽

Cervical Mass ◽

Parathyroid Adenomas ◽

Group 2

OBJECTIVE: To determine the usefulness of parathyroid hormone (PTH) measurement in needle aspirates of a suspicious neck mass to confirm its parathyroid nature in patients with primary hyperparathyroidism. METHODS: Thirty-three patients with surgically proved primary hyperparathyroidism were submitted to neck ultrasound (US), parathyroid scintigraphy, and assay of PTH in the aspirate (PTHa) of the suspicious cervical mass. RESULTS: Based on the results of neck US and parathyroid scintigraphy, patients were divided into two groups. Group 1: 16 patients (seven with nodular goiter) with concordant positive US and scintigraphic results. In all but one patient, PTHa was detectable and often markedly elevated (> 1000 pg in 12 patients, between 292 pg and 803 pg in three patients and 53 pg in one patient). The patient with undetectable PTHa had a small lower left parathyroid adenoma (8x8x10 mm). Group 2: 17 patients (12 with nodular goiter) with discordant US and scintigraphic results. PTHa established the parathyroid nature of the mass in 13 cases (> 1000 pg in 8 patients, between 501 pg and 953 pg in three patients and 90 and 79 pg in two patients): 11 of these had a suspected lesion by US examination but the scintigraphy results were negative; two had a mass that gave positive scintigraphy results but was of uncertain origin according to US: in both cases an intrathyroidal parathyroid adenoma was found. PTHa was undetectable in four cases (three with nodular goiter): all of these had equivocal US results, and three had positive scans and one a negative scan. CONCLUSIONS: Assay of PTHa is a simple method and should be useful for confirming the parathyroid nature of a cervical mass in patients with discordant or non-diagnostic US and scintigraphic results.

Single phase computed tomography is equivalent to dual phase method for localizing hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: A retrospective review

10.7287/peerj.preprints.3058v1 ◽

2017 ◽

Author(s):

Fanny Moron ◽

Alfred Delumpa ◽

Justin Chetta ◽

Danielle Guffey ◽

David Dunaway

Keyword(s):

Single Phase ◽

Parathyroid Glands ◽

Ct Scans ◽

Arterial Phase ◽

Phase Method ◽

Dual Phase ◽

Parathyroid Adenomas ◽

Multiphase Ct ◽

Parathyroid Imaging

Objective: This study aims to compare the sensitivity of dual phase (non-contrast and arterial) versus single phase (arterial) CT for detection of hyper-functioning parathyroid glands in patients with primary hyperparathyroidism. Methods: The CT scans of thirty-two patients who have biochemical evidence of primary hyperparathyroidism, pathologically proven parathyroid adenomas, and pre-operative multiphase parathyroid imaging were evaluated retrospectively in order to compare the adequacy of single phase vs. dual phase CT scans for the detection of parathyroid adenomas. Results: The parathyroid adenomas were localized in 83% of cases on single arterial phase CT and 80% of cases on dual phase CT. The specificity for localization of parathyroid tumor was 96% for single phase CT and 97% for dual phase CT. The results were not significantly different (p=0.695). These results are similar to those found in the literature for multiphase CT of 55-94%. Conclusions: Our study supports the use of a single arterial phase CT for the detection of hyperfunctioning parathyroid adenomas. Advances in knowledge: A single arterial phase CT has similar sensitivity for localizing parathyroid adenomas as dual phase CT and significantly reduces radiation dose to the patient.

Single phase computed tomography is equivalent to dual phase method for localizing hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: a retrospective review

PeerJ ◽

10.7717/peerj.3586 ◽

2017 ◽

Vol 5 ◽

pp. e3586 ◽

Cited By ~ 3

Author(s):

Fanny Morón ◽

Alfred Delumpa ◽

Justin Chetta ◽

Danielle Guffey ◽

David Dunaway

Keyword(s):

Single Phase ◽

Parathyroid Glands ◽

Ct Scans ◽

Arterial Phase ◽

Phase Method ◽

Dual Phase ◽

Parathyroid Adenomas ◽

Multiphase Ct ◽

Parathyroid Imaging

Objective This study aims to compare the sensitivity of dual phase (non-contrast and arterial) versus single phase (arterial) CT for detection of hyper-functioning parathyroid glands in patients with primary hyperparathyroidism. Methods The CT scans of thirty-two patients who have biochemical evidence of primary hyperparathyroidism, pathologically proven parathyroid adenomas, and pre-operative multiphase parathyroid imaging were evaluated retrospectively in order to compare the adequacy of single phase vs. dual phase CT scans for the detection of parathyroid adenomas. Results The parathyroid adenomas were localized in 83% of cases on single arterial phase CT and 80% of cases on dual phase CT. The specificity for localization of parathyroid tumor was 96% for single phase CT and 97% for dual phase CT. The results were not significantly different (p = 0.695). These results are similar to those found in the literature for multiphase CT of 55–94%. Conclusions Our study supports the use of a single arterial phase CT for the detection of hyperfunctioning parathyroid adenomas. Advances in knowledge: a single arterial phase CT has similar sensitivity for localizing parathyroid adenomas as dual phase CT and significantly reduces radiation dose to the patient.