"Before skin incision" high-resolution ultrasound in primary hyperparathyroidism: a new imaging tool for surgeons?
Hyperparathyroidism
Imaging
Thyroid
Ultrasonography
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
31
01
2022
accepted:
22
09
2022
pubmed:
29
9
2022
medline:
25
2
2023
entrez:
28
9
2022
Statut:
ppublish
Résumé
Various diagnostic methods have been utilized for localizing pathologic parathyroid glands to consequently provide the possibility of avoiding bilateral neck dissection in cases of primary hyperparathyroidism. Scintigraphy, combined with ultrasound, became established as the standard method of localization in the 2000s. The aim of this study was to evaluate the role of the "before skin incision" surgeon-performed ultrasound in determining the improvement in the diagnostic accuracy in a large case series. The method used in this research is a retrospective observational study (study period: between 1-2014 and 12-2020) comparing two patient groups before (control group: 31 patients) and after (study group: 70 patients) the introduction of the ultrasonography surgical protocol: combined preoperative and "before skin incision" surgeon-performed ultrasound. The sensitivity of the combined preoperative "before skin incision" surgeon-performed ultrasound was 97%, and the positive predictive value was 93% in regard to detecting the number of diseased glands and the appropriate anatomic location (right versus left, upper versus lower). The sensitivity of the parathyroid scan (Tc-MIBI-scintigraphy) was 74%, and the positive predictive value was 92%. The duration of surgery was significantly shorter in the test group (84.7 vs. 66.4 min; Mann‒Whitney U: 0.006). No differences were detected between the two groups in regard to avoiding intraoperative or postoperative complications. The combination of the preoperative "before skin incision" surgeon-performed ultrasound could improve the efficiency of the preoperative location and anatomic classification using the standard literature-suggested diagnostic methods.
Identifiants
pubmed: 36168005
doi: 10.1007/s00423-022-02697-0
pii: 10.1007/s00423-022-02697-0
doi:
Substances chimiques
Technetium Tc 99m Sestamibi
971Z4W1S09
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3643-3649Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Cobin RH, Gharib H, Bergman DA, Clark OH, Cooper DS, Daniels GH, Dickey RA, Duick DS, Garber JR, Hay ID, Kukora JS, Lando HM, Schorr AB, Zeiger MA (2001) AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. American Association of Clinical Endocrinologists. American College of Endocrinology. Endocr Pract 7(3):202–20
doi: 10.4158/EP.7.3.202
Heath H 3rd, Hodgson SF, Kennedy MA (1980) Primary hyperparathyroidism Incidence, morbidity, and potential economic impact in a community. N Engl J Med 302(4):189–93
doi: 10.1056/NEJM198001243020402
Mundy GR, Cove DH, Fisken R (1980) Primary hyperparathyroidism: changes in the pattern of clinical presentation. Lancet 1(8182):1317–1320
doi: 10.1016/S0140-6736(80)91783-3
Mohebati A, Shaha AR (2012) Imaging techniques in parathyroid surgery for primary hyperparathyroidism. Am J Otolaryngol 33(4):457–568
doi: 10.1016/j.amjoto.2011.10.010
Salazar J, Dembrow V, Egozi I (1986) A review of 265 cases of parathyroid explorations. Am Surg 52(3):174–176
Oertli D, Udelsman R (2007) Surgery of the thyroid and parathyroid glands, vol xv. Springer, Berlin; New York p, p 354
doi: 10.1007/978-3-540-68043-7
Gilat H et al (2005) Minimally invasive procedure for resection of a parathyroid adenoma: the role of preoperative high-resolution ultrasonography. J Clin Ultrasound 33(6):283–287
doi: 10.1002/jcu.20131
(2005) The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons position statement on the diagnosis and management of primary hyperparathyroidism. Endocr Pract 11(1):49–54
Udelsman R, Donovan PI, Sokoll LJ (2000) One hundred consecutive minimally invasive parathyroid explorations. Ann Surg 232(3):331–339
doi: 10.1097/00000658-200009000-00005
Reeder SB, Desser TS, Weigel RJ et al (2002) Sonography in primary hyperparathyroidism: review with emphasis on scanning technique. J Ultrasound Med 21:539–552
doi: 10.7863/jum.2002.21.5.539
Solbiati L, Osti V, Cova L, Tonilini N (2001) Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur Radiol 11(12):2411–2424
doi: 10.1007/s00330-001-1163-7
Freudenberg LS, Frilling A, Sheu SY, Görges R (2006) Optimizing preoperative imaging in primary hyperparathyroidism. Langenbecks Arch Surg 391(6):551–556
doi: 10.1007/s00423-006-0076-y
Feingold DL, Alexander HR, Chen CC, Libutti SK, Shawker TH, Simonds WF, Marx SJ, Skarulis MC, Doppman JL, Schrump DS, Bartlett DL (2000) Ultrasound and sestamibi scan as the only preoperative imaging tests in reoperation for parathyroid adenomas. Surgery 128:1103–1109
doi: 10.1067/msy.2000.109963
Lumachi F, Zucchetta P, Marzola MC, Boccagni P, Angelini F, Bui F, D’Amico DF, Favia G (2000) Advantages of combined technetium-99m-sestamibi scintigraphy and high-resolution ultrasonography in parathyroid localization: comparative study in 91 patients with primary hyperparathyroidism. Eur J Endocrinol 143:755–760
doi: 10.1530/eje.0.1430755
Berczi C, Mezosi E, Galuska L, Varga J, Bajnok L, Lukacs G, Balazs G (2002) Technetium 99m estamibi/pertechnetate subtraction scintigraphy vs. ultrasonography for preoperative localization in primary hyperparathyroidism. Eur Radiol 12:605–609
doi: 10.1007/s003300101045
Jones JM, Russell CF, Ferguson WR, Laird JD (2001) Preoperative sestamibi-technetium subtraction scintigraphy in primary hyperparathyroidism: experience with 156 consecutive patients. Clin Radiol 56:556–559
doi: 10.1053/crad.2001.0701
Taillefer R, Boucher Y, Potvin C, Lambert R (1992) Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study). J Nucl Med 33:1801–1807
Gotway MB, Reddy GP, Webb WR, Morita ET, Clark OH, Higgins CB (2001) Comparison between MR imaging and 99mTc-MIBI scintigraphy in the evaluation of recurrent hyperparathyroidism. Radiology 218:783–790
doi: 10.1148/radiology.218.3.r01fe38783
Moka D, Voth E, Dietlein M, Larena-Avellaneda A, Schicha H (2000) Technetium 99m MIBI-SPECT: a highly sensitive diagnostic tool for localization of parathyroid adenomas. Surgery 128:29–35
doi: 10.1067/msy.2000.107066
De Feo ML, Colagrande S, Biagini C, Tonarelli A, Bisi G, Vaggelli L, Borrelli D, Cicchi P, Tonelli F, Amorosi A, Serio M, Brandi ML (2000) Parathyroid glands: combination of (99m)Tc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology 214:393–402
doi: 10.1148/radiology.214.2.r00fe04393
Ulanovski D, Feinmesser R, Cohen M, Sulkes J, Dudkiewicz M, Shpitzer T (2002) Preoperative evaluation of patients with parathyroid adenoma: role of high-resolution ultrasonography. Head Neck 24(1):1–5
doi: 10.1002/hed.10043
Van Husen R, Kim LT (2004) Accurancy of surgeon-performed ultrasound in parathyroid localization. World J Surg 28(11):1122–1126
doi: 10.1007/s00268-004-7485-2
Boggs JE, Irvin GL, Molinari AS et al (1996) Intraoperative parathyroid hormone monitoring as an adjunct to parathyroidectomy. Surgery 120:954–958 13
doi: 10.1016/S0039-6060(96)80040-7
Gordon LL, Snyder WH, Wians F et al (1999) The validity of quick intraoperative parathyroid hormone assay: an evaluation in seventy-two patients based on gross morphologic criteria. Surgery 126:1030–1035
doi: 10.1067/msy.2099.101833
Perrier ND, Edeiken B, Nunez R, Gayed I, Jimenez C, Busaidy N, Potylchansky E, Kee S, Vu T (2009) A novel nomenclature to classify parathyroid adenomas. World J Surg 33(3):412–416
doi: 10.1007/s00268-008-9894-0
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196
doi: 10.1097/SLA.0b013e3181b13ca2
Krausz Y, Lebensart PD, Klein M, Weininger J, Blachar A, Chisin R, Shiloni E (2000) Preoperative localization of parathyroid adenoma in patients with concomitant thyroid nodular disease. World J Surg 24:1573–1578
doi: 10.1007/s002680010280
Lumachi F, Ermani M, Basso S, Zucchetta P, Borsato N, Favia G (2001) Localization of parathyroid tumours in the minimally invasive era: which technique should be chosen? Population based analysis of 253 patients undergoing parathyroidectomy and factors affecting parathyroid gland detection. Endocr Relat Cancer 8(1):63–69
doi: 10.1677/erc.0.0080063
Scheiner JD, Dupuy DE, Monchik JM, Noto RB, Cronan JJ (2001) Pre-operative localization of parathyroid adenomas: a comparison of power and color Doppler ultrasonography with nuclear medicine scintigraphy. Clin Radiol 56:984–988
doi: 10.1053/crad.2001.0793