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The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

Lookup NU author(s): Sebastian Aspinall, Stewart Nicholson, Richard Bliss, Professor Thomas Lennard

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Abstract

INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit.METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT).RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS).CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

Publication metadata

Author(s): Aspinall SR, Nicholson S, Bliss RD, Lennard TWJ

Publication type: Article

Publication status: Published

Journal: Annals of the Royal College of Surgeons of England

Year: 2012

Volume: 94

Issue: 1

Pages: 17-22

Print publication date: 01/03/2012

Online publication date: 11/03/2015

Acceptance date: 13/08/2011

ISSN (print): 0035-8843

ISSN (electronic): 1478-7083

Publisher: Royal College of Surgeons of England

URL: http://dx.doi.org/10.1308/003588412X13171221498389

DOI: 10.1308/003588412X13171221498389

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