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Titolo:
Localization of parathyroid tumours in the minimally invasive era: which technique should be chosen? Population-based analysis of 253 patients undergoing parathyroidectomy and factors affecting parathyroid gland detection
Autore:
Lumachi, F; Ermani, M; Basso, S; Zucchetta, P; Borsato, N; Favia, G;
Indirizzi:
Univ Padua, Sch Med, Dept Surg & Gastroenterol Sci, Endocrine Surg Unit, I-35128 Padua, Italy Univ Padua Padua Italy I-35128 Endocrine Surg Unit, I-35128 Padua, Italy Univ Padua, Sch Med, Dept Neurosci, I-35128 Padua, Italy Univ Padua Padua Italy I-35128 Med, Dept Neurosci, I-35128 Padua, Italy Univ Padua, Sch Med, Dept Diagnost Med Sci, Nucl Med Serv, I-35128 Padua, Italy Univ Padua Padua Italy I-35128 Sci, Nucl Med Serv, I-35128 Padua, Italy City Hosp, Conegliano, TV, Italy City Hosp Conegliano TV ItalyCity Hosp, Conegliano, TV, Italy
Titolo Testata:
ENDOCRINE-RELATED CANCER
fascicolo: 1, volume: 8, anno: 2001,
pagine: 63 - 69
SICI:
1351-0088(200103)8:1<63:LOPTIT>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
UNILATERAL NECK EXPLORATION; SPORADIC PRIMARY HYPERPARATHYROIDISM; TC-99M SESTAMIBI SCINTIGRAPHY; TC 99M SESTAMIBI; PREOPERATIVE LOCALIZATION; DOUBLE-PHASE; COMPUTED-TOMOGRAPHY; DOPPLER SONOGRAPHY; HORMONE ASSAY; SPECT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
64
Recensione:
Indirizzi per estratti:
Indirizzo: Lumachi, F Univ Padua, Sch Med, Dept Surg & Gastroenterol Sci, Endocrine Surg Unit, Via Giustiniani 2, I-35128 Padua, Italy Univ Padua Via Giustiniani 2 Padua Italy I-35128 Padua, Italy
Citazione:
F. Lumachi et al., "Localization of parathyroid tumours in the minimally invasive era: which technique should be chosen? Population-based analysis of 253 patients undergoing parathyroidectomy and factors affecting parathyroid gland detection", ENDOCR-R CA, 8(1), 2001, pp. 63-69

Abstract

A series of 253 consecutive patients with proved primary hyperparathyroidism due to parathyroid tumours was reviewed. There were 68 (26.9%) men and 185 (73.1%) women, with a median age of 57 years (range 13-82 years). All patients, prior to successful parathyroidectomy, underwent one or more preoperative localization procedures such as: neck ultrasonography (US) in 191 (75.5%), Tl-201/Tc-99m-pertechnetate subtraction scintigraphy (TPS) in 144 (56.9%), CT scan in 92 (36.4%), Tc-99m-sestamibi/Tc-99m-pertechnetate subtraction scintigraphy (M PS) in 90 (35.6%), selective venous sampling (SVS) with parathyroid hormone (PTH) assay in 30 (11.9%), and magnetic resonance imaging (MRI) in 6 (2.4%) patients. The results were compared with operative and histological findings that showed 235 (92.9%) solitary parathyroid adenomas, 13 (5.1%) carcinomas and 5 (2.0%) double adenomas. Sensitivity and positive predictive value were 82.9% and 93.8% for US, 83.6% and 91.8% for TPS, 81.3% and 98.7% for CT scan, 85.1% and 96.1% for MPS, 65.4% and 80.9% forSVS, and 80.0% and 80.0% for MRI respectively, No different results (P = NS) were found using US, TPS, MPS or CT scan, whereas SVS and MRI sensitivity was lower (P < 0.05). The combination of MPS and US was 94.0% sensitive (P < 0.05) but when TPS, CT scan or MRI were also used overall sensitivity did not improve significantly (P = NS). In conclusion, MPS should be used asthe starting preoperative localization procedure, while US and MPS together represent the most reliable noninvasive localization tool, If MPS and US are negative or not in agreement, further studies are not cost-effective and the patient should undergo bilateral neck exploration.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 17/09/19 alle ore 23:06:38