ECEESPE2025 Poster Presentations Bone and Mineral Metabolism (112 abstracts)
Localization imaging and postoperative outcomes in primary hiperparathyroidism (phpt): is less enough?
Daniela M. Soares 1 , Henrique Carmona Alexandrino 2 , Andreia Martins Fernandes 3 , Leandro Augusto Silva 3 , Sofia Lopes 4 , Ana Rita Elvas 3 , Raquel G. Martins 3 , Jacinta Santos 3 , 3 , Teresa Martins 3 , Joana Couto 3 & Fernando Rodrigues 3
1Unidade Local de Saúde de Santo António, Endocrinology, Porto, Portugal; 2Unidade Local de Saúde de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal; 3Instituto Português de Oncologia Francisco Gentil de Coimbra, Coimbra, Portugal; 4Unidade Local de Saúde de Coimbra, Coimbra, Portugal
JOINT938
Background/Aims: Surgery is the first-line established treatment for pHPT; the performance of preoperative localization techniques (LT) increases the probability of a successful parathyroidectomy. Our aim was to characterize the use of two different LT (neck ultrasound (US) and 99mTc-sestamibi scintigraphy (Sci)) and their impact on postoperative outcomes.
Methods: Retrospective study including patients with sporadic pHPT diagnosed and submitted to parathyroidectomy between january 2003 and october 2023 at a tertiary center. Patients with normocalcemic pHPT, without preoperative LT records or whose pHPT was an intraoperative finding were excluded.
Results: 119 patients were included, most of whom were females (86. 6%; n = 103). At diagnosis, median age was 62. 0 (IQR=51. 0-70. 0) years and median ionized calcium (iCa), serum calcium (sCa), and PTH levels were 1. 41 (IQR=1. 37-1. 51) mmol/l (reference 1. 14-1. 29); 11. 3 (IQR=11. 0-12. 0) mg/dL (reference 8. 6-10. 5) and 178. 1 (IQR=143. 3-275. 7) pg/mL (reference 18. 0-80. 0), respectively. US was performed in all patients and Sci in 117 patients (98. 3%). US and Sci located abnormal parathyroid(s) in respectively 75. 6% (n = 90) and 90. 6% (n = 106) of patients; when both were performed, 26. 5% of patients (n = 31) presented positive localization in only one of the techniques. Neck CT and 18F-fluorocholine-PET-CT were additionally performed in 17. 0% (n = 19) and 1. 7% (n = 2) of patients, respectively. Postoperative complications were documented in 16. 8% of patients (n = 16), in which 2. 1% (n = 2) presented iatrogenic hypoparathyroidism. Surgery success rates among all patients globally, patients with positive US only, positive Sci only, both US/Sci positive, both US/Sci negative and one positive with the other negative were 98. 3% (116/118); 87. 5% (7/8); 96. 0% (24/25); 100% (84/84); 50. 0% (1/2) and 93. 5% (29/31), respectively. No statistically significant differences were found between patients with one positive vs two positive LT regarding postoperative complications (18. 5% vs. 16. 7%; P = 1. 000) and calcium levels normalization (96. 9% vs. 100%; P = 0. 276). Additionally, no statistically significant differences were documented between patients with positive US only vs positive Sci only regarding the same outcomes (16. 7% vs. 19. 0%, P = 1. 000; 100% vs. 96. 0%, P = 1. 000).
Conclusion: In this study, the performance of US vs Sci demonstrated no differences regarding postoperative complications or calcemia normalization. Additionally, our results also suggest that one positive imaging exam might be enough to ensure parathyroidectomy success with no differences in the evaluated postoperative outcomes, thus reducing futile use of more preoperative localization techniques.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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