Abstract
The aim of the present study was to evaluate the predictive value of 25-hydroxyvitamin D, calcium and parathormone level, co-existence of thyroid nodule, thyroidectomy history and adenoma volume on the success of neck ultrasound (US) and technetium-99m sestamibi (MIBI) scan in primary hyperparathyroidism (PHP) patients. This study included 256 patients with PHP who underwent parathyroidectomy. 169 (%66) patients had vitamin D deficiency and 56 (%22) of patients had insufficiency. The sensitivity of US and MIBI studies showed no difference between vitamin D deficiency, insufficiency and replete groups (%80.5, %82 and %71 (p > 0.05) and %81, %84 and %71 respectively (p > 0.05)). Vitamin D level was not found to be an independent predictor of localization on either US or MIBI scan after adjusting for different variables (p > 0.05). Calcium level was found to be an independent predictor for US sensitivity (r2:0,033, p:0,032) and parathormone level for MIBI sensitivity (r2:0,05, p:0,025). The co-existence of nodular thyroid disease and history of thyroidectomy significantly decreased the sensitivity of US (%76 and %43). MIBI sensitivity was not impaired by nodular disease but the history of thyroidectomy also impaired the sensitivity of MIBI (%43). As a result vitamin D level does not affect the sensitivity of preoperative localization tests.
Highlights
The study aimed to investigate the effect of the preoperative factors such as vitamin D, Ca and PTH level, co-existence of thyroid nodule, thyroidectomy history, parathyroid adenoma volume and weight on the success of localization studies in primary hyperparathyroidism (PHP) patients
A total of 256 patients who underwent parathyroidectomy for treatment of PHP were included in the study, comprising 214 (%84) females and 42 (%16) males with a mean age of 56 ± 12 years
Full demographic and clinical data are reported in Table 1. 164 (%64) patients had at least one thyroid nodule and 85 (%33) patients had no nodular thyroid disease. 7 (%2.7) patients had thyroid surgery before the diagnosis of PHP
Summary
The aim of the present study was to evaluate the predictive value of 25-hydroxyvitamin D, calcium and parathormone level, co-existence of thyroid nodule, thyroidectomy history and adenoma volume on the success of neck ultrasound (US) and technetium-99m sestamibi (MIBI) scan in primary hyperparathyroidism (PHP) patients
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