The Accuracy of Preoperative Combined Ultrasonography and Sestamibi Scintigraphy in Preoperative Localization of Hyperparathyroidism

Abstract

The difficulty of parathyroid surgery lies not only in reduced size and delicate location of glands among important nerves and vessels, but also in distinguishing an adenoma from hyperplasia, a distinction that can be difficult not only intraoperatively, but sometimes also histolopathologically. Imaging is not for diagnosis as calcium and PTH plasma levels establish the diagnosis of hyperparathyroidism. Imaging is a localization technique for abnormal parathyroid glands and does not identify normal parathyroid glands, which are too small (20-50 mg) to be seen. Successful parathyroidectomy depends on the recognition and excision of all hyperfunctioning parathyroid glands. The success of surgery for HPT depends on accurate preoperative localization of parathyroid adenomas. Preoperative localization is essential for the safety and efficacy of surgery, particularly in the present era of minimally invasive surgery. The aim of this study is to detect the importance of combination of Ultrasonography and Sestamibi scintigraphy in the preoperative localization of patients with hyperparathyroidism to increase the adoption of minimally invasive parathyroidectomy techniques. The combined Ultrasonography and Sestamibi scintigraphy in the preoperative localization of patients with hyperparathyroidism is accurate 90%. In our study, we recommend the combination of preoperative ultrasonography and sestamibi scannirig is effective in predicting the location of pathological parathyroid glands in patients with hyperparathyr