The aim of this study was to evaluate the sensitivity and usefulness of high resolution ultrasonography (US) and dual phase technetium-99m sestamibi (Tc-MIBI) scintigraphy in the preoperative localization of parathyroid lesions in patients with or without thyroid disease and to define the impact of the presence of thyroid disease on these methods. Preoperative US and scintigraphy were performed on 52 patients with primary hyperparathyroidism. Age, gender, preoperative parathyroid hormone level, serum calcium level, serum phosphate level, diameter, location, associated with thyroid abnormality, and results of parathyroid exploration were determined in all patients. The results of US and Tc-MIBI imaging were analyzed and compared with surgical and histopathologic findings. At surgery, 56 parathyroid lesions were found in 52 patients (9 men, 43 women), the parathyroid lesion was solitary (47 adenomas, two hyperplasias), in 2 patients double adenomas were present, in 1 patient three glands was affected by hyperplasia. Twenty-seven patients had concomitant thyroid disease. The overall sensitivity of US and Tc-MIBI scintigraphy was 84% and 73%, respectively. In patients without thyroid disease, the sensitivity of these techniques was 90% and 75%, respectively. In patients with thyroid disease, the sensitivity was 78% and 70%, respectively. In patients with thyroid disease, the combined sensitivity of these techniques was 89%. These results allow the conclusion that, in experienced hands, US is a highly sensitive technique. Especially in patients with no thyroid pathology and typical located gland, US alone should be used as a first step for preoperative localization of parathyroid lesions. When negative, Tc-MIBI scintigraphy is suggested. In patients with concomitant thyroid disease, the combination of US and Tc-MIBI scintigraphy represents a reliable localization technique.
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Sci Rep
January 2025
Department of Ophthalmology, West China Hospital of Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041, Sichuan, China.
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Department of Thyroid Head and Neck Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
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Department of Ultrasound Medicine, China-Japan Friendship Hospital, Beijing100029, China Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing100730, China National Respiratory Medicine Center, National Key Laboratory of Respiratory and Comorbidity, National Respiratory Medical Center National Clinical Research Center, Respiratory Diseases Respiratory Research Institute of Chinese Academy of Medical Sciences, Respiratory Center of China-Japan Friendship Hospital, Beijing100029, China.
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Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China.
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Department of In Vitro Carcinogenesis and Cellular Chemotherapy, Chittaranjan National Cancer Institute, 37, S. P. Mukherjee Road, Kolkata 700026, India. Electronic address:
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