Abstract

Objective: In this study, we aimed to compare the results of ultrasonography and Tc-99m sestamibi dual phase parathyroid scintigraphy with postoperative pathology findings in patients with primary hyperparathyroidism.

Methods: The study was carried out with 96 patients, who had surgical intervention for primary hyperparathyroidism and followed up in the Endocrinology and Metabolism Clinic, between January 2010-December 2015. Demographic data and preoperative laboratory results of the patients were reviewed. Diagnostic accuracy and compliance were calculated by comparing imaging methods with surgical localization and histopathological evaluation results.

Results: Parathyroid adenomas were detected in 75, parathyroid hyperplasia in 12, and parathyroid carcinoma in 5 and suspect pathology results in 4 patients. The mean preoperative calcium (11.25 mg/dl) and parathormone (400.06 pg/ml) levels were determined. Ultrasonography had an estimated diagnostic sensitivity of 58.7% and a specificity of 38.5% in cases with parathyroid adenoma. It was observed that ultrasonography has not any diagnostic significance, and it is not in accordance with histopathological diagnosis (Kappa=-0.018, p=0.851). Diagnostic sensitivity, and specificity of scintigraphy were found to be 58.7%, and 38.5%, respectively. It was observed to be only fairly concordant, and significant according to histopathological diagnosis (Kappa=0.221, p=0.047).

Conclusion: Tc-99m MIBI dual-phase parathyroid scintigraphy, a highly sensitive and noninvasive imaging technique, is clearly superior to the ultrasonography in detecting parathyroid adenomas and locating regions correctly.