Aim To determine a correlation between the localization of the parathyroid gland (PTG), based on ultrasound (US) examination and the operative findings, as well as the correlation between the size of the parathyroid glands measured by ultrasonography (USG) with pathological findings+, and prevalence of enlarged parathyroid glands in various forms of hyperparathyroidism. Methods A total of 83 patients with hyperparathyroidism who had undergone parathyroidectomy over a period of seven years were included in the study. US examinations of the neck and scintigraphy were performed before surgery in 83 and 42 patients, respectively. In the pathohistological analysis, in addition to diagnosis, the size and weight of the parathyroid gland were measured. Results US examination revealed 125 enlarged parathyroid glands and two normal-sized glands. Scintigraphy revealed 52 enlarged and three normal-sized parathyroid glands. Enlarged parathyroid glands were more frequently found in the projection of the lower pole thyroid glands. A significantly higher number of enlarged upper parathyroid glands were found by the operative findings than by US. There was no statistically significant difference in the diagnosis of enlarged parathyroid glands in all three forms of hyperparathyroidism. There was a positive correlation between the size of the parathyroid glands obtained by US and the size of the operative finding (κ=0.51; p=0.00 and p<0.0005, respectively). The relationship between parathyroid gland size measured by ultrasound and pathological analysis showed a positive correlation. Conclusion Ultrasound was useful in evaluating enlarged parathyroid glands, especially in combination with scintigraphy.
Jawaid I, Rajesh S. Hyperparathyroidism (primary) NICE guideline: diagnosis, assessment, and initial management. Br J Gen Pract. 2020;70:362–3.
2.
Islam AK. Advances in the diagnosis and the management of primary hyperparathyroidism. Ther Adv Chronic Dis. 2021;12(20406223211015964).
3.
Palumbo VD, Palumbo VD, Damiano G, Messina M, Fazzotta S, Lo Monte G, et al. Tertiary hyperparathyroidism: a review. Clin Ter. 2021;172:241–6.
4.
Botushanova AD, Botushanov NP, Yaneva MP. Nuclear medicine methods for evaluation of abnormal parathyroid glands in patients with primary and secondary hyperparathyroidism. Folia Med (Plovdiv. 2017;59:396–404.
5.
Lee JB, Kim WY, Lee YM. The role of preoperative ultrasonography, computed tomography, and sestamibi scintigraphy localization in secondary hyperparathyroidism. Ann Surg Treat Res. 2015;89:300–5.
6.
Taterra D, Wong LM, Vikse J, Sanna B, Pekala P, Walocha J, et al. The prevalence and anatomy of parathyroid glands: a meta-analysis with implications for parathyroid surgery. Langenbecks Arch Surg. 2019;404:63–70.
7.
Patel DD, Bhattacharjee S, Pandey AK, Kopp CR, Ashwathanarayana AG, Patel HV, et al. Comparison of 4D computed tomography and F-18 fluorocholine PET for localisation of parathyroid lesions in primary hyperparathyroidism: A systematic review and meta-analysis. Clin Endocrinol (Oxf. 2023;99:262–1.
8.
Abruzzo A, Gioviale MC, Damiano G, Palumbo VD, Buscemi S, Lo Monte G, et al. Reoperation for persistent or recurrent secondary hyperparathyroidism Acta Biomed. Vol. 88. 2017. p. 325–8.
9.
Li W, Zhu Q, Lai X, Sun J, Jiang Y, Ren X, et al. Value of preoperative ultrasound-guided fine-needle aspiration for localization in Tc-99m MIBI-negative primary hyperparathyroidism patients.
10.
Itani M, Middleton WD. Parathyroid Imaging. Radiol Clin North Am. 2020;58:1071–3.
11.
Vestergaard S, Gerke O, Bay M, Madsen AR, Stilgren L, Ejersted C, et al. Head-to-head comparison of Tc-99msestamibi SPECT/CT and C-11-L-Methionin PET/ CT in parathyroid scanning before operation for primary hyperparathyroidism. Mol Imaging Biol. 2023;25:720–6.
12.
Habib A, Molena E, Snowden C, England J. Efficacy of surgeon-performed, intra-operative ultrasound scan for localisation of parathyroid adenomas in patients with primary hyperparathyroidism. J Laryngol Otol. 2023;137:910–3.
13.
Lalonde MN, Correia RD, Syktiotis GP, Schaefer N, Matter M, Prior JO. Parathyroid imaging. Semin Nucl Med. 2023;53:490–2.
14.
Obiarinze R, Chen H, Lindeman B, Fazendin J, Ramonell KM. Parathyroid imaging practices for primary hyperparathyroidism without previous operations among endocrine surgery program directors. Am Surg. 2023;89:277–9.
15.
Park SY, Choi YS, Hwang YM, Yi JW. Robot-assisted parathyroidectomy using indocyanine green (ICG) fluorescence in primary hyperparathyroidism. Medicina (Kaunas. 2023;59(1456).
16.
European Medicines Agency. Guideline for Good Clinical Practice ICH E6 (R2. 2022.
17.
Chen Z, Cheng L, Zhang W, He W. Ultrasound-guided thermal ablation for hyperparathyroidism: current status and prospects. Int J Hyperthermia. 2022;39:466–4.
18.
Gollisch KSC, Siggelkow H. Primary hyperparathyroidism - diagnostic procedures and management (Primärer Hyperparathyroidismus – Diagnostik und Therapie. German] Dtsch Med Wochenschr. 2022;147:187–9.
19.
Chen R, Zhang K, Liu J, Guo L, Liu K, Geng C. Preoperative ultrasound identification and localization of the inferior parathyroid glands in thyroid surgery. Front Endocrinol (Lausanne. 2023;14(1094379).
20.
LoPinto M, Rubio GA, Khan ZF, Vaghaiwalla TM, Farra JC, Lew JI. Location of abnormal parathyroid glands: lessons from 810 parathyroidectomies. J Surg Res. 2017;207:22–6.
21.
Périé S, Fessi H, Tassart M, Younsi N, Poli I, Guily JL, et al. Usefulness of combination of high-resolution ultrasonography and dual-phase dual-isotope iodine 123/technetium Tc 99m sestamibi scintigraphy for the preoperative localization of hyperplastic parathyroid glands in renal hyperparathyroidism. Am J Kidney Dis. 2005;45:344–2.
22.
Mohammadi A, Moloudi F, Ghasemi-rad M. The role of colour Doppler ultrasonography in the preoperative localization of parathyroid adenomas. Endocr J. 2012;59:375–2.
23.
Iwen KA, Kußmann J, Fendrich V, Lindner K, Zahn A. Accuracy of parathyroid adenoma localization by preoperative ultrasound and sestamibi in 1089 patients with primary hyperparathyroidism. World J Surg. 2022;46:2197–5.
24.
Baj J, Sitarz R, Łokaj M, Forma A, Czeczeleeski M, Maani A, et al. Preoperative and intraoperative methods of parathyroid gland localization and the diagnosis of parathyroid adenomas. Molecules. 2020;25(1724).
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