Clinical surgery–InternationalThe positive effect of adenoma weight and oxyphil cell content on preoperative localization with 99mTc-sestamibi scanning for primary hyperparathyroidism
Section snippets
Patients
We performed a retrospective study of 70 consecutive patients with pHPT who underwent parathyroidectomy in the Department of General Surgery at the Istanbul Medical Faculty from 2004 to 2006. The data from 47 patients were analyzed. The remaining 23 patients were excluded because of sestamibi scanning performed at another institution, secondary or tertiary HPT, or multiple endocrine neoplasias, false-positive scan results, incomplete data, or inability to retrieve archived pathology specimens
Patients
Mean age of both groups together was 51 ± 12 years (range 23–77). The female-to-male ratio was 8.4:1 (n = 42 women and 5 men). Mean serum calcium and PTH levels were 12.4 ± .9 mg/dL and 370.85 ± 250 pg/dL, respectively. Mean adenoma weight and oxyphil cell contents were 1,189 ± 1,515 mg (range 132–10,000) and 19% ± 21% (range 1%–80%), respectively. In some cases, oxyphil cells were randomly distributed among chief cells, whereas in others they formed clusters. When they formed clusters, they
Comments
We compared the effects of adenoma weight and oxyphil cell content on sestamibi scan results. Adenoma weight >600 mg and oxyphil cell content >20% were found to be independent factors influencing positive sestamibi scan results. However, in patients with parathyroid adenomas having oxyphil cell contents >20%, positive sestamibi scan results were achieved despite low-weight adenomas. Patients with higher-weight adenomas had positive sestamibi scan results regardless of oxyphil cell content. As
References (24)
- et al.
A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003
Otolaryngol Head Neck Surg
(2005) - et al.
Minimally invasive radioguided parathyroidectomy
Surg Oncol Clin North Am
(1999) - et al.
Prospective evaluation of sestamibi scan, ultrasonography, and rapid PTH to predict the success of limited exploration for sporadic primary hyperparathyroidism
Surgery
(2004) - et al.
Minimally invasive parathyroid surgery
Best Pract Res Clin Endocrinol Metab
(2001) - et al.
Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study
Surgery
(2001) - et al.
Radionuclide imaging of the parathyroid glands
Semin Nucl Med
(2005) - et al.
Cost-effectiveness of preoperative sestamibi scan for primary hyperparathyroidism is dependent solely upon the surgeon’s choice of operative procedure
J Am Coll Surg
(1998) - et al.
Relation of biochemical, cytologic, and morphologic parameters to the result of gammagraphy with technetium 99m sestamibi in primary hyperparathyroidism
Otolaryngol Head Neck Surg
(2000) - et al.
Relationship between sestamibi uptake, parathyroid hormone assay, and nuclear morphology in primary hyperparathyroidism
J Am Coll Surg
(2004) - et al.
Clinical spectrum of primary hyperparathyroidism
Rev Endocr Metab Disord
(2000)
The epidemiology of primary hyperparathyroidism in North America
J Bone Miner Res
Parathyroid surgery: we still need traditional and selective approaches
J Endocrinol Invest J
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Preoperative parathyroid localization. Relevance of MIBI SPECT-CT in adverse scenarios
2023, Endocrinologia, Diabetes y NutricionCitation Excerpt :Our study assessed all these theoretical advantages of SPECT/CT. In this context, some biochemical factors, such as serum calcium or PTH28 and pathological features of parathyroid lesions such as weight and volume,29 percentage of oxyphilic cells,29 cystic component, hyalinization, etc., have been directly related to MIBI uptake and consequently to its sensitivity. In our study, the parathyroid weight was in fact the only factor significantly related to MIBI parathyroid detection, as described previously.26,29
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2022, Journal of Clinical and Translational Endocrinology: Case ReportsCitation Excerpt :Chiu et al. reported mean hyperfunctioning parathyroid gland volume of 1.34 cc and mean weight of 1.128 g in cases with localizing parathyroid imaging [26]. Stephen et al. reported mean weight for true positive scan of 1.336 g and Erbil et al. reported weights over 0.6 g to be correlated with localizing studies [27,28]. In our case, despite change in radiotracer avidity, the mass seen on SPECT/CT and 4D-CT scans remained stable in size and was found to and weigh 1.4g.
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