Endocrine Abstracts

Introduction: Preoperative ultrasonography or Sestamibi scanning (or both) of the parathyroid glands could facilitate a focused or minimally invasive surgical approach. In this audit, we wanted to find out whether one form of imaging is superior to the other in correctly identifying a parathyroid adenoma, later confirmed on histology.

Methods: Data were collected from consecutive patients who underwent parathyroidectomy for primary hyperparathyroidism, conducted by a single Head and Neck Surgeon at a Teaching Hospital in England between March 2012 and October 2014. Core Patient Database (CPD) Software was used to review the ultrasound (USS) and Sestamibi scans reports and histology results. We excluded patients with secondary causes for hyperparathyroidism; parathyroid cancers and familial/inherited causes for hyperparathyroidism.

Results: 57 patients were identified, average age 59 years, 44 females (77.2%) and 13 males (22.8%). A neck USS and Sestamibi scans were both performed in 52 cases. Both scans correctly identified a parathyroid adenoma (confirmed on histology) in 37 cases (71.2%). Only the Sestamibi scan (not USS) correctly identified the parathyroid adenomas in 6 cases (11.5%). Only the USS correctly identified the parathyroid adenomas in six cases (11.5%). While neither scan was able to identify the parathyroid adenoma in five cases (9.6%). Selecting only one modality for imaging, either USS or Sestamibi scan, prior to parathyroidectomy resulted in no adenoma or the wrong adenoma being identified in 21.1% of cases; this risk was reduced to 9.6% when both scans are performed.

Conclusions: Our data support the use of both neck USS and Sestamibi scans prior to parathyroidectomy.