Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy

Joon Ho Kwon, Eun Kyung Kim, Hye Sun Lee, Hee Jung Moon, Jin Young Kwak

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: To evaluate and compare the diagnostic performances of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy for the preoperative localization of abnormal parathyroid glands and to evaluate the ability of US for additional diagnostic roles in detecting thyroid malignancy in patients with pHPT. Materials and methods: Preoperative localization images of 115 parathyroid adenomas from high-resolution ultrasonography (US) and 99mTc-sestamibi scintigraphy (SS) were studied from 105 patients, who had undergone parathyroidectomy. Sensitivity, accuracy, and positive predictive value were calculated for the identification of adenomas in lesions and patients for both US and SS, respectively, and US and SS diagnostic performances were compared using generalized estimating equation. Results: Preoperative imaging by both modalities localized 105 (93.8%) of the 112 parathyroid lesions confirmed at surgery and histology. Sensitivity, accuracy, and positive predictive value were 93.1% and 92.2%, 90.4% and 89.5%, and 96.9% and 96.9% by US and SS, respectively, without any statistically significant differences (P = 0.796, 0.796, 0.879). US found incidental thyroid nodules in 47 patients (47/107, 43.9%), and 7 patients (7/107, 6.5%) were confirmed to have malignancy based on pathology results (all had papillary thyroid carcinoma). Conclusion: Neck ultrasonography and 99mTc-sestamibi scintigraphy are complementary methods of the preoperative localization of parathyroid adenomas. Neck ultrasounds add an additional thyroid gland evaluation, and can be useful in the detection of incidental thyroid gland lesions, especially malignant nodules.

Original languageEnglish
Pages (from-to)e17-e21
JournalEuropean Journal of Radiology
Volume82
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Primary Hyperparathyroidism
Ultrasonography
Thyroid Gland
Neck
Radionuclide Imaging
Technetium Tc 99m Sestamibi
Neoplasms
Parathyroid Neoplasms
Parathyroidectomy
Thyroid Nodule
Parathyroid Glands
Adenoma
Histology
Pathology

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy",
abstract = "Objective: To evaluate and compare the diagnostic performances of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy for the preoperative localization of abnormal parathyroid glands and to evaluate the ability of US for additional diagnostic roles in detecting thyroid malignancy in patients with pHPT. Materials and methods: Preoperative localization images of 115 parathyroid adenomas from high-resolution ultrasonography (US) and 99mTc-sestamibi scintigraphy (SS) were studied from 105 patients, who had undergone parathyroidectomy. Sensitivity, accuracy, and positive predictive value were calculated for the identification of adenomas in lesions and patients for both US and SS, respectively, and US and SS diagnostic performances were compared using generalized estimating equation. Results: Preoperative imaging by both modalities localized 105 (93.8{\%}) of the 112 parathyroid lesions confirmed at surgery and histology. Sensitivity, accuracy, and positive predictive value were 93.1{\%} and 92.2{\%}, 90.4{\%} and 89.5{\%}, and 96.9{\%} and 96.9{\%} by US and SS, respectively, without any statistically significant differences (P = 0.796, 0.796, 0.879). US found incidental thyroid nodules in 47 patients (47/107, 43.9{\%}), and 7 patients (7/107, 6.5{\%}) were confirmed to have malignancy based on pathology results (all had papillary thyroid carcinoma). Conclusion: Neck ultrasonography and 99mTc-sestamibi scintigraphy are complementary methods of the preoperative localization of parathyroid adenomas. Neck ultrasounds add an additional thyroid gland evaluation, and can be useful in the detection of incidental thyroid gland lesions, especially malignant nodules.",
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Neck ultrasonography as preoperative localization of primary hyperparathyroidism with an additional role of detecting thyroid malignancy. / Kwon, Joon Ho; Kim, Eun Kyung; Lee, Hye Sun; Moon, Hee Jung; Kwak, Jin Young.

In: European Journal of Radiology, Vol. 82, No. 1, 01.01.2013, p. e17-e21.

Research output: Contribution to journalArticle

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