caa a22 4500 445335491 CHVBK 20180317142753.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1724-1 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1724-1 What is the Added Benefit of Cervical Ultrasound to 99mTc-Sestamibi Scanning in Primary Hyperparathyroidism? [Elektronische Daten] [Joel Adler, Herbert Chen, Sarah Schaefer, Rebecca Sippel] Background: Minimally invasive parathyroidectomy for primary hyperparathyroidism depends on accurate preoperative imaging, which is traditionally accomplished by 99mTc-sestamibi scanning. Cervical ultrasound is gaining in use, but it is unclear how much information it adds to the routine use of 99mTc-sestamibi scans. Methods: A prospectively maintained database of patients undergoing parathyroidectomy for primary hyperparathyroidism was queried, and the utility of cervical ultrasound in preoperative planning was analyzed. Results: Between July 2002 and November 2009, 310 patients with primary hyperparathyroidism underwent both 99mTc-sestamibi and ultrasound imaging. Ultrasound added new information to 99mTc-sestamibi in 43 patients (14%) by finding either the correct enlarged gland (n=40, 88%) or additional enlarged glands (n=5, 12%). Ultrasound correctly localized glands in 38 of 85 (45%) patients with a negative 99mTc-sestamibi, allowing for a minimally invasive parathyroidectomy in those patients. However, in the 206 patients (66%) who had a 1-gland positive 99mTc-sestamibi, ultrasound only added information for 8 patients (4%). When compared with radiology-performed ultrasound, surgeon-performed ultrasound was successful in localizing additional glands in 27 (15%) versus 17 patients (10%) (P<0.001). Conclusions: Ultrasound led to additional localization information in 14% of patients, although this benefit was less in patients with a clearly positive 1-gland 99mTc-sestamibi scan. Cervical ultrasound provides added benefit to 99mTc-sestamibi scanning in patients with primary hyperparathyroidism, but its greatest utility is when performed by a surgeon in patients with a negative 99mTc-sestamibi scan. Society of Surgical Oncology, 2011 Adler Joel Department of Surgery, Massachusetts General Hospital, Boston, MA, USA aut Chen Herbert Department of Surgery, University of Wisconsin, Madison, WI, USA aut Schaefer Sarah Department of Surgery, University of Wisconsin, Madison, WI, USA aut Sippel Rebecca Department of Surgery, University of Wisconsin, Madison, WI, USA aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2907-2911 1068-9265 18:10<2907 2011 18 10434 https://doi.org/10.1245/s10434-011-1724-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1724-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Adler Joel Department of Surgery, Massachusetts General Hospital, Boston, MA, USA aut NATIONALLICENCE 700 1- Chen Herbert Department of Surgery, University of Wisconsin, Madison, WI, USA aut NATIONALLICENCE 700 1- Schaefer Sarah Department of Surgery, University of Wisconsin, Madison, WI, USA aut NATIONALLICENCE 700 1- Sippel Rebecca Department of Surgery, University of Wisconsin, Madison, WI, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2907-2911 1068-9265 18:10<2907 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer