Diagnostic accuracy of ultrasound in preoperative assessment of primary hyperparathyroidism
J Randall1, S Malthouse2, P Maddox3, J Lawrence1 & A Robinson1
Preoperative localisation of parathyroid adenomas may allow more limited neck exploration. Ultrasound is the least expensive imaging technique available. However, correct localisation may be difficult. We have undertaken a study to see whether asking one radiologist (SM) to perform all scans offers a diagnostic advantage.
All patients undergoing surgery for primary hyperparathyroidism since June 1998 were included. Ultrasound and histology reports and patient notes were used to identify which radiologist performed the scan and the location of the adenoma at surgery.
28 patients had ultrasounds, performed by 6 radiologists. 21 of these were undertaken by SM.
6/21 scans performed by SM failed to localise an adenoma, compared with 5/7 scans performed by other radiologists (p<0.05).
13/21 adenomas were localised to the correct side by SM compared with 2/7 by other radiologists (p<0.05).
Ultrasound to localise parathyroid adenomas is better performed by a single operator. However, still only 62% of adenomas were correctly localised, suggesting ultrasound has a limited role in the management of hyperparathyroidism.