Usefulness of combined ultrasonography and scintigraphy in the preoperative assessment of secondary or tertiary hyperparathyroidism

• Published in: Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica Vol. 34; no. 2; p. 63
• Main Authors: Oliva, A R, Lobos, P A, Moldes, J M, Liberto, D H
• Format: Journal Article
• Language: English
• Published: Spain 01.04.2021
• Subjects: Child; Humans; Hyperparathyroidism - diagnostic imaging; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Sestamibi; Ultrasonography; Ultrasonography; Parathyroidectomy; Parathyroid scintigraphy; Hyperparathyroidism
• ISSN: 2445-2807

To determine whether combined ultrasonography and parathyroid scintigraphy improves hyperplastic parathyroid gland detection in the pediatric population for parathyroidectomy planning in patients with secondary or tertiary hyperparathyroidism. An observational and analytical retrospective cohort study was carried out. Patients diagnosed with secondary or tertiary hyperparathyroidism from 2011 to 2018 undergoing total or subtotal parathyroidectomy were included - provided there was information available on pathological examination and surgical protocol. N = 15 patients. A total of 53 parathyroid glands diagnosed with hyperplasia using either of the imaging methods were analyzed. For each method (ultrasonography and scintigraphy) and the combination of both, sensitivity and area under the curve were calculated, using pathological examination result as a reference. Ultrasonography and scintigraphy diagnostic match was 66%. The intraoperative difficulty of parathyroid gland identification as well as the anatomical variation that these present is well-known. Ultrasonography detected more glands than scintigraphy when diagnosing parathyroid hyperplasia. The combination of both methods allows patients with a first negative study to be detected.