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Original research article


Does contrast-enhanced cervical ultrasonography improve preoperative localization results in patients with sporadic primary hyperparathyroidism

Elias KarakasSusanne KannHelmut HöffkenDetlef Klaus BartschIlhan CelikChristian GörgAndreas Pfestroff
Departments of Visceral, Thoracic and Vascular Surgery, Nuclear Medicine, Internal Medicine, Hematology, Oncology and Immunology, University Hospital Marburg, Germany
Date of Submission: 02-Aug-2012, Date of Acceptance: 07-Sep-2012, Date of Web Publication: 31-Oct-2012.
Corresponding Author:
Corresponding Author

Elias Karakas

Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, Baldinger Street, 35043 Marburg, Germany.
E-mail: karakas@med.uni-marburg.de

Corresponding Author:
Corresponding Author

Elias Karakas

Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, Baldinger Street, 35043 Marburg, Germany.
E-mail: karakas@med.uni-marburg.de

DOI: 10.4103/2156-7514.103054 Facebook Twitter Google Linkedin

ABSTRACT



Objective: Pre-operative localization studies are inevitable in patients with primary hyperparathyroidism (pHPT), who are eligible for focused or minimally invasive parathyroidectomy (MIP). High-resolution ultrasonography (US) in combination with planar 99mTc-Sestamibi-scintigraphy (MIBI) and additional single-photon emission computed tomography (SPECT) are the standard procedures to localize enlarged parathyroid glands. Our aim was to evaluate the practicability and significance of contrast-enhanced ultrasonography (CEUS) in patients with pHPT.
Materials and Methods: All investigations were performed at the University Hospital Marburg. Totally, 25 patients with biochemical proven pHPT underwent preoperative US, MIBI/SPECT, and CEUS. For CEUS, a suspension of phospholipid-stabilized sulfurhexafluoride (SF6) microbubbles in combination with a special 12 MHz linear US probe was used. All patients were investigated by two sonographers, who did not get to view the findings noted by the other. Finally, surgery was performed and histopathological results were obtained from 24 patients.
Results: In 17 (68%) patients, US and MIBI/SPECT already raised suspicion of parathyroid lesions and all suspected lesions were reassessed by CEUS. However, no additional information was obtained using CEUS. Especially in eight patients with negative or inconsistent US and MIBI/SPECT results, CEUS did not provide additional information regarding the site of the suspected parathyroid adenoma. Overall, no side effects were observed using CEUS. Surgical cure was achieved in all patients.
Conclusion: In this limited cohort of patients, no additional information could be obtained using the costly CEUS compared to results of US and MIBI/SPECT.
Keywords: 99mTc-Sestamibi/single-photon Emission Computed Tomography, Contrast-enhanced Ultrasonography, Primary Hyperparathyroidism, Ultrasonography

Cited in 1 Document

  1. Shannon M. Navarro, Harshawn Malhi, Corinne Deurdulian and Edward Grant (2019) Localization of Parathyroid Adenoma Using Contrast‐Enhanced Sonography. J Ultrasound Med 38(1):259. doi: 10.1002/jum.14672

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