Primary Hyperparathyroidism: To Evaluate Benefit of Ultrasound and Tc99m-SESTAMIBI Scan in Localizing Abnormal Parathyroid Gland Before Surgery, in a Secondary Care Hospital
Introduction Primary hyperparathyroidism is a common endocrine condition requiring parathyroidectomy for curative management. Localization of parathyroid gland by ultrasound and Tc99m-SESTAMIBI is important to opt for less invasive and comparatively lower complication risk surgery minimal invasive p...
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Published in | Curēus (Palo Alto, CA) Vol. 12; no. 8; p. e10155 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Palo Alto (CA)
Cureus
31.08.2020
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Abstract | Introduction
Primary hyperparathyroidism is a common endocrine condition requiring parathyroidectomy for curative management. Localization of parathyroid gland by ultrasound and Tc99m-SESTAMIBI is important to opt for less invasive and comparatively lower complication risk surgery minimal invasive parathyroidectomy (MIP) instead of four-gland exploration surgery.
Aim
To evaluate ultrasound and Tc99m-SESTAMIBI in localization of abnormal parathyroid gland before surgery.
Method and materials
All patients of primary hyperparathyroidism (PHPT) that presented to a secondary care hospital (endocrinology department) from 2015-2019 were recruited retrospectively from electronic fusion system of hospital. Results of ultrasound parathyroid and Tc99m-SESTAMIBI done for localization of abnormal parathyroid gland were analyzed.
Results
Total PHPT patients recruited were 59, mean age 64.2 years, male 11 (18.64%) and female 48 (81.3%). Ultrasound parathyroid was done in 44 patients, Tc 99m-SESTAMIBI was done in 31, both tests were done in 31 patients. Combined concordant adenoma in both tests was seen in 11 (35%) cases which can opt for minimal invasive parathyroidectomy (MIP) with confidence whereas 65% of cases would require either four-gland exploration or further testing like single-photon emission computed tomography-computed tomography (SPECT-CT) or intraoperative parathyroid hormone measurement to opt for MIP.
Conclusion
Combined ultrasound parathyroid and Tc 99m-SESTAMIBI scan was useful in localization of parathyroid adenoma in 11 (35%) patients that can opt for MIP which is a lower complication risk surgery whereas 20 (65%) patients would need further investigation with SPECT-CT or intraoperative parathyroid hormone measurement or four-gland exploration surgery.
Recommendation
Third modality of investigation such as SPECT-CT or intraoperative parathyroid hormone measurement needs evaluation so that more patients can benefit from MIP instead of four-gland exploration surgery. |
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AbstractList | Introduction
Primary hyperparathyroidism is a common endocrine condition requiring parathyroidectomy for curative management. Localization of parathyroid gland by ultrasound and Tc99m-SESTAMIBI is important to opt for less invasive and comparatively lower complication risk surgery minimal invasive parathyroidectomy (MIP) instead of four-gland exploration surgery.
Aim
To evaluate ultrasound and Tc99m-SESTAMIBI in localization of abnormal parathyroid gland before surgery.
Method and materials
All patients of primary hyperparathyroidism (PHPT) that presented to a secondary care hospital (endocrinology department) from 2015-2019 were recruited retrospectively from electronic fusion system of hospital. Results of ultrasound parathyroid and Tc99m-SESTAMIBI done for localization of abnormal parathyroid gland were analyzed.
Results
Total PHPT patients recruited were 59, mean age 64.2 years, male 11 (18.64%) and female 48 (81.3%). Ultrasound parathyroid was done in 44 patients, Tc 99m-SESTAMIBI was done in 31, both tests were done in 31 patients. Combined concordant adenoma in both tests was seen in 11 (35%) cases which can opt for minimal invasive parathyroidectomy (MIP) with confidence whereas 65% of cases would require either four-gland exploration or further testing like single-photon emission computed tomography-computed tomography (SPECT-CT) or intraoperative parathyroid hormone measurement to opt for MIP.
Conclusion
Combined ultrasound parathyroid and Tc 99m-SESTAMIBI scan was useful in localization of parathyroid adenoma in 11 (35%) patients that can opt for MIP which is a lower complication risk surgery whereas 20 (65%) patients would need further investigation with SPECT-CT or intraoperative parathyroid hormone measurement or four-gland exploration surgery.
Recommendation
Third modality of investigation such as SPECT-CT or intraoperative parathyroid hormone measurement needs evaluation so that more patients can benefit from MIP instead of four-gland exploration surgery. |
Author | Yousuf, Quratulain Rabbi, Jamal Mian, Fahd Qadir, Mamoon Rafique, Yasmeen Rehman, Habib U Krishnasamy, SenthilKumar |
AuthorAffiliation | 1 General Medicine, Endocrinology, Kulsum International Hospital, Islamabad, PAK 2 Endocrinology, Diabetes and Metabolism, Walsall Manor Hospital, Walsall, GBR 3 Cardiac Surgery, Kulsum International Hospital, Islamabad, PAK 4 Cardiology, Polyclinic Hospital, Islamabad, PAK 5 Internal Medicine, Benazir Bhutto Hospital, Rawalpindi, PAK |
AuthorAffiliation_xml | – name: 1 General Medicine, Endocrinology, Kulsum International Hospital, Islamabad, PAK – name: 4 Cardiology, Polyclinic Hospital, Islamabad, PAK – name: 3 Cardiac Surgery, Kulsum International Hospital, Islamabad, PAK – name: 2 Endocrinology, Diabetes and Metabolism, Walsall Manor Hospital, Walsall, GBR – name: 5 Internal Medicine, Benazir Bhutto Hospital, Rawalpindi, PAK |
Author_xml | – sequence: 1 givenname: Habib U surname: Rehman fullname: Rehman, Habib U – sequence: 2 givenname: SenthilKumar surname: Krishnasamy fullname: Krishnasamy, SenthilKumar – sequence: 3 givenname: Jamal surname: Rabbi fullname: Rabbi, Jamal – sequence: 4 givenname: Mamoon surname: Qadir fullname: Qadir, Mamoon – sequence: 5 givenname: Yasmeen surname: Rafique fullname: Rafique, Yasmeen – sequence: 6 givenname: Fahd surname: Mian fullname: Mian, Fahd – sequence: 7 givenname: Quratulain surname: Yousuf fullname: Yousuf, Quratulain |
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Cites_doi | 10.4137/CMED.S13114 10.1210/jc.2018-02483 10.5858/2009-0578-CCR.1 10.1001/jamasurg.2016.2310 10.1016/j.ehj.2004.07.010 10.4158/EP.10.6.472 10.4183/aeb.2019.182 10.4103/ijem.IJEM_445_16 10.5858/2008-132-1251-PHACP |
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References | Andersson P (ref6) 2004; 25 Calò PG (ref11) 2013; 6 Mallikarjuna VJ (ref1) 2018; 22 Rodríguez-Carranza S (ref8) 2004; 10 Carlson D (ref3) 2010; 134 Urkan M (ref10) 2019; 15 Melton LJ (ref2) 2002; 17 DeLellis RA (ref4) 2008; 132 Reid LJ (ref5) 2019; 104 Wilhelm SM (ref7) 2016; 151 NICE guideline (ref9) 2019 |
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Title | Primary Hyperparathyroidism: To Evaluate Benefit of Ultrasound and Tc99m-SESTAMIBI Scan in Localizing Abnormal Parathyroid Gland Before Surgery, in a Secondary Care Hospital |
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