A new classification of positive sestamibi and ultrasound scans in parathyroid localization

Orhan Agcaoglu, Shamil Aliyev, Katy Heiden, Donald Neumann, Kresimira Milas, Jamie Mitchell, Allan E. Siperstein, Eren Berber

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Ultrasound (US) and sestamibi (MIBI) are traditionally considered positive or negative. The purpose of this study was to define and test a new scoring system for MIBI and US and to determine whether this can improve their accuracy for primary hyperparathyroidism. Methods This is a prospective study of 200 consecutive patients with primary hyperparathyroidism who had a single uptake on MIBI scans before bilateral neck exploration at a tertiary academic center between 2007 and 2008. These patients also had surgeon-performed neck US in the office, which was scored as "typical" or "atypical" based on how characteristic the image resembled a parathyroid gland. The MIBI uptake was scored by the nuclear medicine specialist as "weak," "moderate," or "strong" compared with the signal intensity of the thyroid. US and MIBI scoring was done preoperatively and their findings were compared with operative data. Results Of 200 patients, 71 % had a single adenoma, 12 % had double adenomas, and 17 % had four-gland hyperplasia. A weak, moderate, and strong signal on MIBI had an accuracy of 23, 47, and 72 %, respectively, in demonstrating single-gland disease. An atypical versus typical US appearance was accurate in 55 and 74 % of the time, in identifying single-gland disease. Conclusions An appraisal of US and MIBI positivity in relation to image characteristics affects the reliability of both studies. This information should be kept in mind when selecting patients for focal neck exploration.

Original languageEnglish (US)
Pages (from-to)2516-2521
Number of pages6
JournalWorld Journal of Surgery
Volume36
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

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Neck
Primary Hyperparathyroidism
Adenoma
Parathyroid Glands
Nuclear Medicine
Hyperplasia
Thyroid Gland
Prospective Studies
Surgeons

ASJC Scopus subject areas

  • Surgery

Cite this

Agcaoglu, O., Aliyev, S., Heiden, K., Neumann, D., Milas, K., Mitchell, J., ... Berber, E. (2012). A new classification of positive sestamibi and ultrasound scans in parathyroid localization. World Journal of Surgery, 36(10), 2516-2521. https://doi.org/10.1007/s00268-012-1666-1

A new classification of positive sestamibi and ultrasound scans in parathyroid localization. / Agcaoglu, Orhan; Aliyev, Shamil; Heiden, Katy; Neumann, Donald; Milas, Kresimira; Mitchell, Jamie; Siperstein, Allan E.; Berber, Eren.

In: World Journal of Surgery, Vol. 36, No. 10, 10.2012, p. 2516-2521.

Research output: Contribution to journalArticle

Agcaoglu, O, Aliyev, S, Heiden, K, Neumann, D, Milas, K, Mitchell, J, Siperstein, AE & Berber, E 2012, 'A new classification of positive sestamibi and ultrasound scans in parathyroid localization', World Journal of Surgery, vol. 36, no. 10, pp. 2516-2521. https://doi.org/10.1007/s00268-012-1666-1
Agcaoglu, Orhan ; Aliyev, Shamil ; Heiden, Katy ; Neumann, Donald ; Milas, Kresimira ; Mitchell, Jamie ; Siperstein, Allan E. ; Berber, Eren. / A new classification of positive sestamibi and ultrasound scans in parathyroid localization. In: World Journal of Surgery. 2012 ; Vol. 36, No. 10. pp. 2516-2521.
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