Analysis of intraoperative laboratory measurements and imaging techniques such as Tc-99m-MIBI SPECT/CT, 18F-fluorocholine PET/CT and ultrasound in patients operated with prediagnosis of parathyroid adenoma.

Abstract

The aim of this study is to determine accurately the localization of the adenoma with the imaging methods in the patients, who are planned to be operated on with prediagnosis of parathyroid adenoma. In our study, the files of the patients who were considered to have parathyroid adenoma and underwent operation between 2012 and 2020 with the methods such as Tc99m-MIBI SPECT/CT, 18F-fluorocholine PET/CT, and ultrasound, and biochemical examinations were examined retrospectively. In this study, 31 (18.2%) male and 139 (81.8%) female adult patients were included. The sensitivities of localization methods were 82.6% for ultrasound and 78.4% for scintigraphy. Adenoma was localised in the right place in 14 of 15 (93.3%) patients with the 18F-fluorocholine PET/CT method. A statistically significant correlation was found between the sensitivity of scintigraphy, the gland weights (p: 0.002), and phosphor values (p: 0.039). A statistically significant improvement was observed in the intact PTH value (p: 0.001) 15min after the removal of adenoma. A statistically significant improvement was observed in the serum PTH value (p: 0.001), the serum phosphorus value (p: 0.001), and the serum calcium (p: 0.001) in the first 3months after the operation. Determining localization accurately for the patients enables performing operations with minimally invasive surgery successfully in a shorter time. Also, fewer complications and faster recovery are seen in the patients. It was concluded that studying intraoperative intact PTH and using 18F-fluorocholine PET/CT method for localization give more accurate results for localization and allow having more successful operation outcomes.