Improved localization of sestamibi imaging at high-volume centers

Michael C. Singer, Darko Pucar, Manoj Mathew, David J Terris

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objectives/Hypothesis: Sestamibi imaging can provide critical information regarding the location of suspected parathyroid adenomas. However, this modality can be challenging to perform and interpret reliably. The impact of experience on the localizing efficacy of sestamibi scanning was assessed. Study Design: Prospective analysis of a consecutive series of patients undergoing parathyroidectomy was undertaken after institutional review board approval was obtained. Methods: Patients undergoing parathyroid surgery from October 2003 through June 2011 were considered. Inclusion criteria represented primary surgery for primary hyperparathyroidism, in which a single adenoma was excised and cure obtained. Sestamibi scan results, performed at our institution and at outside imaging centers, were compared to intraoperative findings. Results: There were 389 parathyroidectomies performed; 188 patients met inclusion criteria. Fifty-four patients had sestamibi scans performed at outside institutions; 36 (67%) were localizing and 18 (33%) were nonlocalizing. Among localizing studies, half identified the correct quadrant and half recognized the correct side. At our institution, 147 patients underwent sestamibi imaging; 121 (82%) localized and 26 (18%) did not. Among localizing studies, the correct quadrant was reported in 64% and the correct side in 36%. Of the 147 scans performed at our institution, 13 represented repeat scans of patients with nonlocalizing outside scans. All 13 of these localized; six identified the correct quadrant and seven the side of the adenoma. Conclusions: A high volume of experience may improve the yield of sestamibi imaging. Repeating this study at a high-volume center when it was nonlocalizing elsewhere may provide useful additional information. Laryngoscope, 2013

Original languageEnglish (US)
Pages (from-to)298-301
Number of pages4
JournalLaryngoscope
Volume123
Issue number1
DOIs
StatePublished - Jan 1 2013

Keywords

  • Level of Evidence: 4
  • Parathyroidectomy
  • clinical competence
  • imaging
  • minimally invasive
  • parathyroid
  • sestamibi

ASJC Scopus subject areas

  • Otorhinolaryngology

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