Abstract
From 1982 to 1985, twenty-nine patients with suspected hyperparathyroidism were examined using201Tl-99mTc subtraction scintigraphy (Tl-Tc), computed tomography (CT) and ultrasonography (US). For diagnosing neoplasm (adenoma or cancer), the sensitivities of the three procedures were 80 per cent or more, with no statistically significant differences. For diagnosing hyperplasia of the parathyroid glands, CT scan had the highest sensitivity (47 per cent). The most frequent source of error was minimally enlarged glands, weighing less than 500 mg. The second highest source of error was thyroid nodules, such as adenomatous goiter or cancer. Serum calcium and c-PTH levels were significantly higher in those with a parathyroid neoplasm than in those with hyperplasia (p<0.01, p<0.05, respectively). We concluded that hyperplasia is less easy to detect than neoplasm, and CT scan is superior to Tl-Tc or US scan for localizing hyperplasia.
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Ferlin G, Borsato N, Gamerani M, Conte N, Zotti D. New perspectives in localizing enlarged parathyroids by technetium-thallium subtraction scan. J Nucl Med 1983; 24: 438–441.
Roza AM, Wexler MJ, Stein L, Goltzman D. Value of high-resolution computerized tomography in localizing diseased parathyroid glands. Can J Surg 1984; 27: 334–336.
Scheible W, Deutch AL, Leopold GR. Parathyroid adenoma: accuracy of preoperative localization by high resolution real-time sonography. JCU 1981; 9: 325–330.
Simeone JF, Mueller PR, Ferrucci JT, van Sonnenberg E, Wang CA, Hall DA, Wittenberg J. Highresolution real-time sonography of the parathyroid. Radiology 1981; 141: 745–751.
Strauss HW, Harrison K, Pitt B. Tallium-201 noninvasive determination of the regional distribution of cardiac output. J Nucl Med 1977; 18: 1167–1170.
Reading CC, Charboneau JW, James EM, Karsell PR, Purnell EC, Grant CS, van Heerden JA. High-resolution parathyroid sonography. AJR 1982; 139: 539–546.
Stark DD, Gooding GAW, Moss AA, Clark OH, Ovenfors CO. Parathyroid imaging: comparison of high-resolution CT and high-resolution sonography. AJR 1983; 141: 633–638.
Takagi H, Tominaga Y, Uchida K, Yamada N, Ishii T, Morimoto T, Yasue M. Preoperative diagnosis of secondary hyperparathyroidism using computed tomography. J Comput Assist Tomogr 1982; 6: 527–528.
Dunlop DAB, Papapulos SE, Lodge RW, Fulton AJ, Kendall BE, O'Riordan JLH. Parathyroid venous sampling: anatomic considerations and results in 95 patients with primary hyperparathyroidism. Br J Radiol 1980; 53: 183–191.
Clark OH, Okerlund MD, Moss AA, Stark D, Norman D, Newton TH, Duh QY, Arnaud CD, Harris S, Gooding GAW. Localization studies in patients with persistent or recurrent hyperparathyroidism. Surgery 1985; 98: 1083–1094.
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Kobayashi, S., Miyakawa, M., Kasuga, Y. et al. Parathyroid imaging: Comparison of201Tl-99mTc subtraction scintigraphy, computed tomography and ultrasonography. The Japanese Journal of Surgery 17, 9–13 (1987). https://doi.org/10.1007/BF02470578
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DOI: https://doi.org/10.1007/BF02470578