title: Parathyroid adenoma localization: surgeon-performed ultrasound versus sestamibi.
abstract: OBJECTIVE
  Compare surgeon-performed ultrasound versus sestamibi for preoperative parathyroid adenoma localization.
  
  
  METHODS
  Single-institutional cohort.
  
  
  METHODS
  One hundred six consecutive patients undergoing parathyroidectomy at an academic institution between 2004 to 2005 were included. Of those, 103 underwent both surgeon-performed ultrasound and sestamibi-Tc99m localization preoperatively. Primary outcome is sensitivity for adenoma localization to correct quadrant (right vs. left, superior vs. inferior).
  
  
  RESULTS
  Hypercalcemia resolved in 97% of patients. Sensitivities for correct quadrant localization for ultrasound versus sestamibi were 87% versus 58% (P < .001). Specificities were 95%. Positive and negative predictive values were 85% versus 78% and 96% versus 87%, respectively. Combined sensitivity was 93%. Sensitivities for correct side localization were 91% and 74% (P = .002).
  
  
  CONCLUSIONS
  Ultrasound appears more sensitive than sestamibi for localization to correct quadrant or side when performed in-office by the author in this cohort.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH 45267, USA. David.Steward@uc.edu
authors.forename: David L
authors.initials: DL
authors.lastname: Steward
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Danielson
authors.forename: Chad E
authors.initials: CE
authors.lastname: Afman
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Welge
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis; D006961:Hyperparathyroidism / Q000175:diagnosis; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography
chemical_list: D017256:Technetium Tc 99m Sestamibi