title: Surgeon-performed ultrasound as preoperative localization study in patients with primary hyperparathyroidism.
abstract: BACKGROUND
  Minimally invasive parathyroidectomy is the treatment of choice for single-gland primary hyperparathyroidism. However, the exact location of the abnormal gland has to be established. Sestamibi scintigraphy, computed tomography and ultrasound (US) are commonly used modalities. We describe our experience in a non-academic center with surgeon-performed US (S-US) of the neck as preoperative localization study in patients with primary hyperparathyroidism (PHPT).
  
  
  METHODS
  Patients with a biochemically proven diagnosis of PHPT and preoperative S-US were included. Data were recorded prospectively. Perioperative gland location was compared to the preoperative S-US to determine sensitivity, specificity and accuracy rates.
  
  
  RESULTS
  Two of the 50 patients who underwent S-US were not subjected to surgery. In 85% of the patients analyzed by S-US, the appropriate abnormal gland(s) were identified. In 11%, no gland was identified, but abnormal glands were found during surgery. Sensitivity of S-US in our hospital is 85%, with a positive predictive value of 97%.
  
  
  CONCLUSIONS
  We achieved a satisfactory sensitivity rate. S-US provides anatomic information to the surgeon which enables a more detailed operation planning, and it is a valuable diagnostic modality for patients with PHPT in our opinion. We hope that our data encourage other centers to implement this technique as well.
authors.affiliation: Reinier de Graaf Groep, Department of Surgery, Delft, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: van Ginhoven
authors.forename: A N
authors.initials: AN
authors.lastname: Morks
authors.forename: T
authors.initials: T
authors.lastname: Schepers
authors.forename: P W
authors.initials: PW
authors.lastname: de Graaf
authors.forename: P C
authors.initials: PC
authors.lastname: Smit
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006761:Hospitals; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009426:Netherlands; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult