Can ultrasound replace sestamibi scans in the pre-operative evaluation of patients with primary hyperparathyroidism?
Background: Pre-operative localization studies may allow directed and more limited surgery in patients with primary hyperparathyroidism. Ultrasound is inexpensive, avoids radiation exposure and allows detection of concurrent thyroid disease but is operator-dependent and does not detect ectopic glands. Sestamibi can detect ectopic disease and is less operator-dependent but costs more, involves radiation and may be inaccurate in patients with thyroid disease. The optimal pre-operative localization study is a matter of some debate.
Explore this issue:October 2013
Study design: Multi-institutional prospective study.
Setting: Universities of Iowa, Kansas, Minnesota, Nebraska and South Dakota-Sanford.