Endocrine Abstracts (2009) 20 P223

Should we offer combination scan in all patients with parathyroid disease: a district general hospital experience

Apurva Sinha, Afaq Siddiqui, Raj Siddhan, Makam Kishore & V Parkinathan

Geoge Eliot Hospital NHS Trust, Nuneaton, West Midland, UK.

Introduction: Tc 99m sestamibi scan and ultrasound are been used most frequently than other imaging technique in the pre operative localization of parathyroid gland in primary hyperparathyroidism. We liked to evaluate our hospital experience with the scan in preoperative localization of the glandular disease.

Method and material: It was a retrospective audit of 7 years from 2000–2007 of 48 patient who underwent open explorative procedure by single surgeon.The scans were compared with that of histology report and data analysed.

Result: Parathyriod adenoma was the most common pathology in our patient cohort (44/49–88%). Approximately half of the patients had combination scan (sestamibi and ultrasound) with high preoperative localization in 92% (24/26). Ultrasound and sestamibi scan done alone had low preoperative sensitivity in gland localization.

Conclusion: We can conclude that if we use the combination scan then there is high probability (93% from our study) of gland localization preoperatively. We should offer the combination scan routinely to all patients in preoperative work up our patients.

This is more likely to localize gland early and help surgeon in discussing focussed parathyroidectomy as a day case surgery in a unigalndular parathyroid adenoma. It would widen the treatment option for the patients with uniglandular adenoma for short stay and day case surgery.

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