Preoperative imaging for hyperparathyroidism often takes upper parathyroid adenomas for lower adenomas

We retrospectively evaluated how accurately preoperative imaging localizes parathyroid adenoma in superior versus inferior parathyroids. Over 6 years, 104 patients with primary hyperparathyroidism underwent parathyroid surgery in a single centre. Of these, 103 underwent ultrasound, 97 [ 99m Tc]perte...

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Bibliographic Details
Published in:Scientific reports 2023-05, Vol.13 (1), p.7568-7568, Article 7568
Main Authors: Van den Bruel, Annick, Bijnens, Jacqueline, Van Haecke, Helena, Vander Poorten, Vincent, Dick, Catherine, Vauterin, Tom, De Geeter, Frank
Format: Article
Language:English
Subjects:
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Adenoma
Adenoma - diagnostic imaging
Adenoma - surgery
Computed tomography
Endocrinology
Humanities and Social Sciences
Humans
Hyperparathyroidism
Hyperparathyroidism - diagnostic imaging
Hyperparathyroidism - surgery
Localization
multidisciplinary
Parathyroid
Parathyroid Neoplasms - complications
Parathyroid Neoplasms - diagnostic imaging
Parathyroid Neoplasms - surgery
Patients
Positron Emission Tomography Computed Tomography
Retrospective Studies
Science
Science (multidisciplinary)
Single photon emission computed tomography
Sodium Pertechnetate Tc 99m
Surgery
Thymus gland
Thyroid gland
Tumors
Ultrasonic imaging
Ultrasound
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Summary:We retrospectively evaluated how accurately preoperative imaging localizes parathyroid adenoma in superior versus inferior parathyroids. Over 6 years, 104 patients with primary hyperparathyroidism underwent parathyroid surgery in a single centre. Of these, 103 underwent ultrasound, 97 [ 99m Tc]pertechnetate/MIBI SPECT/CT and 30 [ 18 F]fluorocholine (FCH) PET/CT. One patient with a unilateral double adenoma was excluded from the analysis. Surgical findings with histopathologic confirmation of adenoma were used as the standard. Ultrasound misjudged 5 of 48 detected lower adenomas as upper, but 14 of 29 upper adenomas as lower (error rate 10 vs 48%, p = 0.0002). The corresponding error rates for [ 99m Tc]pertechnetate/MIBI SPECT/CT were 3 versus 55% (p = 0.000014), and for [ 18 F]FCH PET/CT 17 versus 36% (p = 0.26). Our results suggest that about half of the superior parathyroid adenomas which are detected, are erroneously assigned to the inferior position by both ultrasound and SPECT/CT imaging whereas the opposite mistake is significantly less frequent with ultrasound and SPECT/CT.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-023-32707-0