Jackson R, Chew D, McClean S, England J. Factors related to a non-localising technetium 99m sestamibi scan result during parathyroid adenoma imaging in primary hyperparathyroidism.
Clin Otolaryngol 2020;
46:357-362. [PMID:
33259140 DOI:
10.1111/coa.13677]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/12/2020] [Accepted: 11/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES
The aim of this study is to investigate factors that are associated with having a non-localising 99m Tc-sestamibi scan.
DESIGN
A retrospective study was performed on patients that underwent parathyroid surgery performed within a single institution between 2001 and 2018.
SETTING
Single tertiary centre for parathyroid surgery.
PARTICIPANTS
230 patients underwent surgery for primary hyperparathyroidism due to a solitary parathyroid adenoma and had preoperative 99m Tc-sestamibi imaging.
MAIN OUTCOME MEASURES
Variables including age, gender, intra-operative location of parathyroid adenoma, adenoma weight and pre- and postoperative calcium and parathyroid hormone levels were investigated through univariate and multivariate analysis to identify any association with having a non-localising (negative) 99m Tc-sestamibi scan result.
RESULTS
Multivariate analysis identified that right-sided adenomas (P = .038), superior adenomas (P = .042) and a lower preoperative PTH level (P = .034) were all individual factors associated with having a negative 99m Tc-sestamibi scan result. Although the weight of the adenoma was significant on univariate analysis (P = .029), this was not demonstrated on multivariate analysis (P = .422).
CONCLUSION
Factors that were associated with having non-localising 99m Tc-sestamibi scan were right-sided adenomas, superior adenomas and lower preoperative PTH level. Further large prospective multicentre studies are needed to further evaluate these initial findings.
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