Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2021) 77 P24 | DOI: 10.1530/endoabs.77.P24

SFEBES2021 Poster Presentations Bone and Calcium (22 abstracts)

Hyperparathyroid service evaluation at the Royal Cornwall Hospital Trust from 2013 to 2021

Adele Beck , Jack Looker , Venkat Reddy , Ben Rock & Duncan Browne

Royal Cornwall Hospital Trust, Truro, United Kingdom

Introduction: Primary hyperparathyroidism affects 0.3% of the general population1. 90% are due to single parathyroid adenoma1. Surgical treatment is the only definitive cure2. Improvements in imaging permit radiologists to better identify parathyroid adenomas1, enabling more targeted surgery1, thus shortening general anaesthesia, as well as lowering post-operative complication rates. Neck ultrasound (US) and parathyroid scintigraphy (MIBI) are commonly used together for adenoma detection.1,2 The aim of our quality improvement project was to evaluate the parathyroid service at the Royal Cornwall Hospital Trust (RCHT). We identified what imaging (US/MIBI/both) was performed, adenoma detection rate, surgical intervention and overall patient outcome.

Methods: We performed CRIS data search of patients undergoing MIBI from March 2013 to March 2021, assembling a log of all parathyroidectomies, relevant histopathological records and examining biochemistry records (PTH and calcium) pre- and post-surgery.

Results: 201 parathyroid surgeries were performed over 9 years. Of 201 patients, six underwent US only, 44 underwent MIBI only, and 151 benefitted from both US and MIBI. 82 patients undergoing both US and MIBI had a concordant imaging result whilst 5 had discordant results. The remainder demonstrated an adenoma on either US (19) or MIBI (40) only. Three patients were excluded as they only had planar SPECT imaging. A combination of USS and MIBI had the highest true positive rate (87%) vs MIBI only (76%), USS only (59%). Over nine years, 422 MIBI were performed for 201 surgeries. The success rate of patients undergoing surgery was 93%. Furthermore, 64 patients who were diagnosed with primary hyperparathyroidism were aged fifty or younger. 11 patients were screened for MEN1, two of whom with subsequently confirmed diagnosis.

Conclusion: Over 75% of patients undergo US and MIBI. Discordancy was low between US and MIBI (3.3%), although less than 50% of patients who had MIBI proceeded to surgery.

Volume 77

Society for Endocrinology BES 2021

Edinburgh, United Kingdom
08 Nov 2021 - 10 Nov 2021

Society for Endocrinology 

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