Sensitivity of localization studies performed by various radiologists in the evaluation of parathyroid lesions

Abstract

Objective. Preoperative imaging studies are commonly used in the diagnosis of primary hyperparathyroidismto increase the success rate of surgery. In the present study, we aimed to correlate surgical outcomes with thesensitivity of localization studies that were performed by various radiologists. Methods. One hundred eightynine patients with preoperative diagnosis primary hyperparathyroidism were included. A total of 174 patientsin whom hypercalcemia had been cured by parathyroidectomy, were evaluated retrospectively. In total, 184lesions were excised from these 174 patients. Ultrasonography (USG) and technetium-99m-methoxy isobutylisonitrile (99mTc-MIBI) imaging yielded correctly localized lesion in 74 and 108 patients, respectively. Results.The specificity of USG and 99mTc-MIBI imaging were similar (95.9% and 95.0%, respectively). However,the sensitivity was not satisfactory (45.9% for USG, 62.4% for 99mTc-MIBI). The gland size was not significantfor the rate of lesion detection by 99mTc-MIBI scan or USG. Significant differences were not observed betweenthe preoperative serum parathormone, serum calcium or 24-hour urine calcium excretion levels and the successrate of localization with either USG or 99mTc-MIBI. Conclusions. Radiologist experience in ultrasonographicparathyroid imaging was found to affect sensitivity. Therefore, surgeons, radiologists and endocrinologists thatperform ultrasonographic evaluation should have extensive experience