Inappropriate requesting of parathyroid scintigraphy at an academic medical center.
Head Neck 2021;
43:3404-3407. [PMID:
34378837 DOI:
10.1002/hed.26839]
[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: 02/21/2021] [Revised: 05/29/2021] [Accepted: 07/29/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND
Primary hyperparathyroidism is a biochemical, not radiologic diagnosis. Parathyroid scintigraphy should only be requested for surgical planning, not to confirm diagnosis. Here we determined reasons for inappropriately ordered parathyroid scintigraphy.
METHODS
We generated a database of patients undergoing parathyroid scintigraphy over 5 years, who did not undergo parathyroidectomy.
RESULTS
Over 5 years 129 parathyroid scintigraphies (of 308 total scans) were performed in patients who did not undergo parathyroidectomy. We determined that only 58 (45%) had true primary hyperparathyroidism. The most common reason for the scan was to "confirm the diagnosis." Only 20% were ordered for adenoma localization, although surgery was not performed. Physicians requesting parathyroid scintigraphies specialized in a variety of disciplines.
CONCLUSION
Forty-two percent of parathyroid scintigraphies were requested inappropriately to "confirm" a diagnosis of primary hyperparathyroidism. We propose to change the ordering system to clarify that parathyroid scintigraphy is a functional tool to optimize surgery when the diagnosis is secure.
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