%0 Journal Article
%T Additional Imaging Following a Negative Sestamibi Scan in Primary Hyperparathyroidism
%A Bas Twigt
%A Anne Vollebregt
%A Piet de Hooge
%A Alex Muller
%A Thijs van Dalen
%J International Journal of Otolaryngology and Head &amp; Neck Surgery
%P 93-98
%@ 2168-5460
%D 2012
%I Scientific Research Publishing
%R 10.4236/ijohns.2012.13019
%X &lt;b&gt;Background:&lt;/b&gt; The objective of this study was to assess the additional yield of US and CT following a “negative” initial MIBI-scintigraphy (MIBI) in patients with primary hyperparathyroidism. &lt;b&gt;Methods:&lt;/b&gt; Prospective data were collected regarding 100 consecutive patients, preferentially undergoing a minimally invasive parathyroidectomy (MIP). MIBI was the initial imaging study for localizing a solitary adenoma, followed by US and CT (US/CT) in “MIBI-negative”-patients. &lt;b&gt;Results:&lt;/b&gt; Surgery led to normocalcemia in 98 patients (98%) after one operation. Overall 97 patients had solitary parathyroid disease while three patients had multiglandular disease. The sensitivity of imaging increased from 74% for MIBI alone to 92% following subsequent US/CT in “MIBI-negative”-patients. The positive predictive value of a “positive” MIBI was 96% and 76% of a positive US/CT following negative MIBI. The proportion of patients who underwent successful MIP increased from 60 to 72%. &lt;b&gt;Conclusions:&lt;/b&gt; MIBI and the combination of US and CT are complementary imaging studies. Additional localization studies after a negative sestamibi scan enhances the number of patients with primary hyperparathyroidism profiting from a minimally invasive approach.
%K Imaging-Primary Hyperparathyroidism-Sestamibi Scan-Ultrasound-CT
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=25073