Comparison Of Sestamibi Scintigraphy And Ultrasonography In Preoperative Localization Of Primary Hyperparathyroidism

Abstract

Aims To determine the utility of ultrasonography for the preoperative localization of enlarged parathyroid glands in primary hyperparathyroidism, and to compare this method with 99m technetium sestamibi scintigraphy. Patients and Methods The results of ultrasonography for localization of enlarged parathyroid glands were determined in 80 consecutive patients with primary hyperparathyroidism and compared with findings at surgery and with the results of 99m technetium sestamibi scintigraphy. Results Ultrasonography predicted surgical findings in 61 of 80 patients (76.1%), including 59 of 76 patients with solitary parathyroid adenomas (77.6%) with a sensitivity of 83.5 % and a positive predictive value (PPV) of 89.7%. Sestamibi scintigraphy findings were correlated with surgical findings in 63 (78.8%) patients including 62 of 76 patients with solitary eutopic parathyroid adenomas (81.5%), with a sensitivity of 85 % and a PPV of 91.3%. Conclusion Sensitivity and positive predictive values of ultrasonography are not significantly different from values of sestamibi scintigraphy in localization of pathologic parathyroid glands in primary hyperparathyroidism.