Parathyroid Adenoma Localization: Surgeon-Performed Ultrasound Versus Sestamibi

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Abstract

Objectives:

Compare surgeon-performed ultrasound versus sestamibi for preoperative parathyroid adenoma localization.

Study Design:

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.

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