Correlation between Surgical Outcomes of Primary Hyperparathyroidism with Neck Ultrasound and Parathyroid Scan-Tc99m/MIBI Localization Studies in Dubai Hospital

Abstract

Objective: The aim of this study is to assess the correlation between the findings in preoperative localization studies and biochemical parameters with the surgical outcome in patients with primary hyperparathyroidism. Design and Methods: In patients with hyperparathyroidism, preoperative localization imaging studies are considered important for their role in surgical cure, operative length, and extent of surgical incision. Sometimes discordant imaging studies lead to further extensive diagnostic work-up to avoid operative risks and may result in delay to surgical referral. In this single-center retrospective study at a tertiary referral center in Dubai, we evaluated the concordance of presurgical imaging modalities in primary hyperparathyroidism with the surgical outcome after parathyroidectomy. Results: This study included n = 59 patients. 74.6% were female, and the mean age was 52.59 years (SD = 13.6). Preoperative parathyroid sestamibi scans were done on n = 50 patients with 68% having a positive result. A radiology department neck ultrasound was done on n = 42 patients, 52% of whom had a positive finding for a parathyroid adenoma, while n = 17 patients required an endocrinology department neck ultrasound scan with 71% having a positive finding. Complete concordance of findings with the postoperative pathology result was found in 78% of patients who had a preoperative parathyroid sestamibi, 78% of patients who had a preoperative radiology department neck ultrasound, and 86% of patients with a preoperative endocrinology department ultrasound. There was no correlation between the preoperative laboratory values of calcium and PTH with the scan findings based on our data. Conclusion: Our results showed a high degree of complete concordance between the usual imaging modalities and surgical findings.

Keywords

• primary hyperparathyroidism
• parathyroid
• neck ultrasound
• technetium-99m-sestamibi