[Preoperative noninvasive tests for localization of enlarged parathyroid glands in 115 patients with hyperparathyroidism].
OBJECTIVE
To evaluate results of preoperative localisation techniques in patients operated for hyperparathyroidism (HPT).


METHODS
Rotterdam University Hospital.


METHODS
Retrospective study.


METHODS
Results of 4 non-invasive preoperative localisation techniques in 115 patients with HPT were compared with operative findings of 116 explorations. Sensitivity and specificity were calculated for single versus multiple gland disease, primary exploration versus re-explorations and anatomical versus ectopic localisation.


RESULTS
Sensitivity of preoperative ultrasound, thallium-technetium subtraction scintigraphy, computed tomography and 99mTc-sestamibi (MIBI) scanning in patients with single gland disease was 56%, 65%, 67% and 83% respectively. In multiple gland disease preoperative localisation techniques were much less successful. For MIBI scintiscanning this question remains unanswered. Specificity of all techniques was high. Success rates of preoperative localisation studies for primary operations and re-explorations were similar. Mean weight of parathyroid tumours that were missed preoperatively was lower than of successfully localised tumours. Only computed tomography and thallium-technetium scintigraphy were able to localise retrosternal parathyroid tumours.


CONCLUSIONS
Review of the literature reveals that there is additional benefit of the preoperative localisation studies in re-exploration for HPT, in contrast to primary exploration. By combining localisation techniques more tumours are visualised. Preliminary results of MIBI scanning are favourable.
van der Harst
E
E
Afd. Algemene Heelkunde, Academisch Ziekenhuis Rotterdam-Dijkzigt.
Bonjer
H J
HJ
Pols
H A
HA
Laméris
J S
JS
Oei
H Y
HY
Bruining
H A
HA
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000473:pathology; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013667:Technetium; D013793:Thallium; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D013667:Technetium; D013793:Thallium
Preoperatieve non-invasieve lokalisatieonderzoeken van vergrote bijschildklieren bij 115 patiënten met hyperparathyreoïdie.