Ultrasound facilitates minimally invasive parathyroidectomy in patients lacking definitive localization from preoperative sestamibi scan.
BACKGROUND
Sestamibi scanning is commonly used for preoperative localization in patients with hyperparathyroidism. However, 12% to 15% of these studies are equivocal or negative. Ultrasound may also be used to identify patients suitable for a minimally invasive parathyroidectomy.


METHODS
Data from patients treated for hyperparathyroidism between January 2000 and April 2006 were reviewed retrospectively. Sestamibi and ultrasound results were scored as definitive, suggestive, or negative. Patients with suggestive or negative sestamibi scans were included in the analysis.


RESULTS
A total of 261 patients underwent operation without a definitively localizing sestamibi scan. Preoperative neck ultrasound was performed in 80 of these patients. Overall, ultrasound was either conclusive or suggestive in 45 of 80 patients (56%) without a definitively localizing sestamibi scan and correctly correlated with the surgical findings in 38 of 45 (84%) of these patients.


CONCLUSIONS
In patients with nonlocalizing sestamibi scans, neck ultrasound increases the number of patients suitable for minimally invasive parathyroidectomy.
Davis
Matthew L
ML
Department of Surgery, Scott & White Memorial Hospital and the Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center College of Medicine, 2401 S. 31st St, Temple, TX 76508, USA.
Quayle
Frank J
FJ
Middleton
William D
WD
Acosta
Lori M
LM
Hix-Hernandez
Staci J
SJ
Snyder
Samuel K
SK
Moley
Jeffrey F
JF
Brunt
L Michael
LM
Lairmore
Terry C
TC
D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D002118:Calcium