Abstract
Background and aims
Surgery is the only curative treatment for primary hyperparathyroidism. Focused surgical techniques are being practiced with increasing frequency. Preoperative imaging, such as scintigraphy, is a prerequisite for focused surgery. There is controversy about which preoperative imaging method should be used. The sensitivity reported for parathyroid scintigraphy varies considerably. This study was designed to determine the accuracy of the preoperative imaging routinely used at our institution.
Material and methods
This retrospective study included consecutive patients who underwent a routine dual-phase sestamibi-SPECT (single photon emission computed tomography) scintigraphy and subsequent operation with follow-up. Scintigraphy results were evaluated by comparing the results to surgical findings and histopathology.
Results
Two hundred and sixty-four individuals entered the study. Sensitivity for scintigraphy was 84%, specificity 91%, positive predictive value 91%, and negative predictive value 84%.
Conclusions
Sestamibi-SPECT scintigraphy is a sensitive preoperative modality with high positive predictive value. Scintigraphy is a good indicator for when to perform a focused surgical approach and could often correctly guide the actual operation.
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Acknowledgements
The authors thank Linköping University. Part of this study was included in the medical degree at Linköping University.
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Best of Endocrine Surgery in Europe 2009.
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Lindqvist, V., Jacobsson, H., Chandanos, E. et al. Preoperative 99Tcm-sestamibi scintigraphy with SPECT localizes most pathologic parathyroid glands. Langenbecks Arch Surg 394, 811–815 (2009). https://doi.org/10.1007/s00423-009-0536-2
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DOI: https://doi.org/10.1007/s00423-009-0536-2