Pre-operative localization of parathyroid adenomas: a comparison of power and colour Doppler ultrasonography with nuclear medicine scintigraphy.
OBJECTIVE
To compare power and colour Doppler ultrasonography (US) with nuclear medicine scintigraphy (NM) in the preoperative localization of parathyroid adenomas in patients with primary hyperparathyroidism (PHPT).


METHODS
Thirty-one patients with biochemical evidence of PHPT underwent pre-operative US and NM for parathyroid adenoma localization. Both studies were interpreted independently without prior knowledge of the other study's findings. All patients had surgical removal of the parathyroid adenoma utilizing standard neck exploration or minimally invasive unilateral surgical techniques with rapid serum assay of circulating parathyroid hormone levels.


RESULTS
All patients had single parathyroid adenomas at surgery. Prospective sensitivities for US, NM and both studies combined were 65%, 68%, and 74%, respectively, with a positive predictive value of 100% each. The adenoma was localized by only one imaging modality in 16% of cases.


CONCLUSIONS
US and NM provide complementary roles in the pre-operative localization of parathyroid adenomas in patients with PHPT.
Scheiner
J D
JD
Department of Diagnostic Imaging, Brown University School of Medicine, Rhode Island Hospital, Providence, Rhode Island 02903, USA. jscheiner@lifespan.org
Dupuy
D E
DE
Monchik
J M
JM
Noto
R B
RB
Cronan
J J
JJ
D000236:Adenoma / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D018615:Ultrasonography, Doppler, Color / Q000379:methods
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi