Role of Imaging in the Localization of Parathyroid Adenoma
|
|
- Horatio Newton
- 6 years ago
- Views:
Transcription
1 Role of Imaging in the Localization of Parathyroid Adenoma Authors S A Kabir 1, Z Khanzada 2, S I Akhtar 3, S I Kabir 4, N Wariach 1, 1. Department of Surgery, Lincoln County Hospital, Lincoln LN2 5QY, United Kingdom. 2. Department of Colorectal Surgery, University Hospital of Wales, Cardiff, UK. 3. Department of Surgery, Kings Mill Hospital, Sutton-in-Ashfield, United Kingdom. 4. Department of Surgery, Wycombe General Hospital, High Wycombe. HP11 2TT, United Kingdom. Corresponding Author S A Kabir adnankabir58@hotmail.com Lead Consultant Mr. Irfan Akhtar, Department of Surgery, Kings Mill Hospital, Sutton-in-Ashfield, United Kingdom. The Online Journal of Clinical Audits, Vol 6(2) Published June 2014 To subscribe to The Online Journal of Clinical Audits go to: Article submission and authors instructions:
2 Aims - Recently minimally invasive parathyroidectomy has been developed. For this reason, preoperative localization is playing an important role to detect the precise location of the affected gland and to increase success rate. It has been mentioned in the literature that if preoperative localization of parathyroid gland is considered necessary the investigations of choice are 99Tc Sestamibi scanning, and High-resolution ultrasonography. Therefore, the aim of this study is to evaluate the choice of investigation in localizing parathyroid adenoma. Methods - Retrospective Study, Imaging, Frozen section & qpth reports of patients [n= 37] with diagnosis of primary hyperparathyroidism who had undergone parathyroidectomy were reviewed, at King Mills Hospital between May 2010 and Dec Results - 37 patients underwent combined USS & Sestamibi scan, Parathyroid adenoma was localized via USS 25/37 (67.56%), as against 34/37 (91.89%) by Sestamibi-scan and by combined i.e. USS & Sestamibi-Scan 36/37 (97.29%). Histology reported adenomas 32/37 (86.48%), hyperplasia 2/37 (5.40%), carcinoma 1/37 (2.7%), normal histology 2/37 (5.40%) (USS & mibi scan Negative). In addition to the above, intra operative qpth showed high levels in 35/37 cases out of which 2 continue to have high levels even after repeating the qpth levels; both patients had normal histology post operatively; out of which 1 was re-operated (adenoma) the other refused surgery. Conclusions - Combined USS and Sestamibi-scan was found to localize parathyroid adenomas with high degrees of accuracy in our hospital (97%). There is also an advantage of doing quick PTH levels compared to frozen section. Introduction Hyperparathyroidism is a disease characterized by high serum calcium levels along with elevated parathyroid hormone (PTH) levels, which occurs with a prevalence of 3/1000 in the general population. 1 In 1925, Mandl 2 performed the first Parathyroidectomy in a patient who suffered with severe bone disease. Since then, the treatment of hyperparathyroidism has undergone dramatic changes over the last 20 years, mainly due to the development of new technological advances in imaging such as Ultrasound scans (USS), Sestamibi scans (Mibi-scan), Computer-Tomographic scans (C.T) and Magnetic Resonance scans (MRI-scan), to help us accurately localize abnormal glands preoperatively. It is important to note that in the hands of an experienced surgeon bilateral neck exploration for Primary Hyper-Parathyroid (PHP) cures 95% of the cases, 3 i.e. without the use of imaging to locate the parathyroid gland, and it is due to this very reason that the National Institutes of Health (NIH) released guidelines in 1990 for the treatment of PHP; Included recommendation that pre-operative localization was not indicated 4. However, with the advent of rapid intra-operative qpth assays and highly sensitive (90.7%) and specific (98.8%) Mibi-scan 2 has rekindled interest in pre-operative localization of parathyroid gland for direct unilateral exploration also known as the Focused Approach.
3 In addition to the above, it is also due to these aforementioned new technological advances that minimally invasive parathyroidectomy has been developed and preoperative localization is playing an important part in detecting the precise location of the affected parathyroid gland to increase its success rate. Authors have suggested that if preoperative localization is considered necessary the investigations of choice are 99Tc Sestamibi scanning, and High-Resolution ultrasonography, and this will be required if a focused approach & limited neck dissection is to be performed. 2 Aims The main aim of this study is to evaluate the choice of investigation in localizing parathyroid adenoma prior to minimal invasive parathyroid surgery. Audit Standards If pre-operative localization of the parathyroid gland is considered necessary i.e. a focused approach and limited neck dissection is to be performed; the investigations of choice are 99Tc Sestamibi scanning, and High-Resolution ultrasonography. 2 Methods We did a retrospective study with Imaging, frozen section & qpth reports of thirty eight (38) patients with a diagnosis of primary hyperparathyroidism, and who underwent minimal invasive parathyroidectomy, were reviewed, at King Mills Hospital between May 2010 and Dec One of the patients had a C.T scan after negative bilateral exploration for parathyroidectomy, and was excluded from the study as did not have any previous imaging. Results A total of 37 patients (n=37) underwent combined USS & Sestamibi scan, except one (1) CT after negative bilateral exploration. Parathyroid adenoma was localized via USS 25/37 (67.56%), as against 34/37 (91.89%) by Sestamibi-scan and by combined i.e. USS & Sestamibi-Scan 36/37 (97.29%) (Figure1). Only one (1) patient underwent CTscan, after bilateral negative parathyroid exploration, 1/1 (100%).
4 Figure 1 Figure 2 Confirming our results with the histology reports, adenomas 34/37, 91.89% (1 bilateral), hyperplasia 2/37 (5.40%), carcinoma 1/37(2.7%), normal histology 1/37 (2.7%) (Figure 2), the patient had bilateral neck exploration after negative USS & mibi scan), intra operative qpth showed high levels in 35/37 cases out of which 1/35 continue to have high levels and had normal post-op histology, the patient was re-operated after C.T confirmation of adenoma. Discussion/Conclusions There is no doubt that with the advent of rapid intra-operative qpth assays and highly sensitive (90.7%) and specific (98.8%) Mibi-scan 1 has rekindled interest in preoperative localization of parathyroid gland for minimal invasive procedures.
5 However, our study has shown that combined approach i.e. USS and mibi-scan was found to localize parathyroid adenomas with high degrees of accuracy in our hospital (97.29%). Only One (1) patient, who had gone through both the imaging, unfortunately could not be picked up initially but, was later localized with C.T. Also, there is also an advantage of doing quick PTH levels compared to frozen section in helping us with the diagnosis as results of frozen section takes time to complete. If initially both USS and Mibi-scan does not locate the parathyroid gland then we should aim for a C.T, rather than go straight for surgery. Recommendations We would recommend the use of both USS and Mibi-scan along with the use of C.T scan if parathyroid gland could not be localized by initial means. References: 1 Adami S, Marcocci C, Gatti D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 2002; 17(Suppl 2): N William B Inabnet, James A. Lee. Parathyroid disease, syndromes and pathophysiology. Companion to specialist surgical practice, Endocrine surgery. 4th Edn. pp Van Heerden J. Lessons learned. Surgery 1997; 122(6): Consensus Development Conference Panel. Diagnosis and management of a symptomativ primary hyperparathyroidism: Consensus Development Conference statement. Ann Intern Med 1991; 114:593-7.
Minimally invasive parathyroidectomy
Minimally invasive parathyroidectomy Jessica E. Gosnell MD Assistant Professor of Surgery March 22, 2011 1 Minimally invasive parathyroidectomy 1. What? 2. When? 3. How? 4. Convert? 5. What adjuncts? Primary
More informationUse of PTH at Point of Surgery for Non-Localized Cases of Hyperparathyoidism
Use of PTH at Point of Surgery for Non-Localized Cases of Hyperparathyoidism Keck Hospital of USC Private, non-profit 400 bed hospital Teaching and research, USC Keck School of Medicine Approx. 40 parathyroid
More informationThe CaPTHUS Scoring Model revisited: Applicability from. with Primary Hyperparathyroidism
wjoes The CaPTHUS Scoring Model revisited: Applicability from a UK Cohort 10.5005/jp-journals-10002-1199 with Primary Hyperparathyroidism Original Article The CaPTHUS Scoring Model revisited: Applicability
More informationMarcin Barczynski, 1 Aleksander Konturek, 2 Alicja Hubalewska-Dydejczyk, 2. Filip Gołkowski, 1 Stanislaw Cichon, 1 Piotr Richter, 1 Wojciech Nowak
3 rd Chair and Department of General Surgery 1 and Chair and Department of Endocrinology 2 Jagiellonian University, Medical College Head: Prof. Wojciech Nowak, MD, PhD INTRAOPERATIVE BILATERAL INTERNAL
More informationComplementary sestamibi scintigraphy and ultrasound for primary hyperparathyroidism
Nuclear Medicine and Biomedical Imaging Research Article Complementary sestamibi scintigraphy and ultrasound for primary hyperparathyroidism Yang Z 1,3 *, Li AY 2, Alexander G 3 and Chadha M 3 1 Department
More informationParathyroid Imaging What is best
Parathyroid Imaging What is best Mike Avison Bradford Why me? I m honoured to be asked to present this. There is no killer paper or text which clearly proves the best methodology. Bradford has performed
More informationOutline. Parathyroid Localization Studies. Mira Milas MD, FACS Associate Professor of Surgery Director, The Thyroid Center
Parathyroid Localization Studies Mira Milas MD, FACS Associate Professor of Surgery Director, The Thyroid Center Outline Clinical Context of Primary Hyperparathyroidism Ultrasound, Sestamibi, and Other
More informationResearch Article Primary Hyperparathyroidism: 11-Year Experience in a Single Institute in Thailand
International Endocrinology Volume 2012, Article ID 952426, 4 pages doi:10.1155/2012/952426 Research Article Primary Hyperparathyroidism: 11-Year Experience in a Single Institute in Thailand Poramaporn
More informationPTH > 60pg/ml PRIMARY HYPERPARATHYROIDISM. Introduction Biochemical Diagnosis. Normal Parathyroid. Parathyroid Glands
next speaker: Declan Neeson Belfast/UK SPECT/CT scanning and parathyroid surgery in Southern Trust, N. Ireland D Neeson M Korda, G Gray, C Leonard, M Fawzy, R Lambon Parathyroid Glands PRIMARY HYPERPARATHYROIDISM
More informationO~iginalArtrc!~'" MINIMALLY INVASIVE RADIO-GUIDED PARATHYROIDECTOMY IN 152 CONSECUTIVE PATIENTS WITH PRIMARY HYPERPARATHYROIDISM
O~iginalArtrc!~'",,_.~.~_.,_,,~_......_. ~.o:-'';:...:/-.~. ~'.:::.., MINIMALLY INVASIVE RADIO-GUIDED PARATHYROIDECTOMY IN 152 CONSECUTIVE PATIENTS WITH PRIMARY HYPERPARATHYROIDISM Douglas Politz, MD,
More informationCase 2: 30 yr-old woman with 7 yr history of recurrent kidney stones
Case 2: 30 yr-old woman with 7 yr history of recurrent kidney stones Giuliano Mariani Regional Center of Nuclear Medicine, University of Pisa Medical School, Pisa (Italy) 30 yr-old woman with 7 yr history
More informationCase 4: 27 yr-old woman with history of kidney stones and hyperparathyroidism.
Case 4: 27 yr-old woman with history of kidney stones and hyperparathyroidism. Giuliano Mariani Regional Center of Nuclear Medicine, University of Pisa Medical School, Pisa (Italy) Hyperparathyroidism
More informationORIGINAL ARTICLE. Sestamibi Scans and Intraoperative Parathyroid Hormone Measurement in the Treatment of Primary Hyperparathyroidism
ORIGINAL ARTICLE Sestamibi Scans and Intraoperative Parathyroid Hormone Measurement in the Treatment of Primary Hyperparathyroidism Eric J. Bergson, MD; Laura A. Sznyter, MD; Sanford Dubner, MD; Christopher
More informationHYPERPARATHYROIDIS M FAISAL GHANI SIDDIQUI MBBS; FCPS; PGDIP-BIOMEDICAL ETHICS; MCPS-HPE
HYPERPARATHYROIDIS M FAISAL GHANI SIDDIQUI MBBS; FCPS; PGDIP-BIOMEDICAL ETHICS; MCPS-HPE PROFESSOR OF SURGERY J I N N A H S I N D H M E D I C A L U N I V E R S I T Y PREAMBLE Anatomy & physiology of the
More informationWomen s Health in General Practice Symposium 2015 Thyroid & Parathyroid Cases
Women s Health in General Practice Symposium 2015 Thyroid & Parathyroid Cases Bill Fleming Epworth Freemasons Hospital 1 Common Endocrine Presentations anatomical problems thyroid nodule / goitre embryological
More informationPARATHYROID IMAGING. James Lee, MD Chief, Endocrine Surgery Co-Director NY Thyroid-Parathyroid Center Columbia University Medical Center
PARATHYROID IMAGING James Lee, MD Chief, Endocrine Surgery Co-Director NY Thyroid-Parathyroid Center Columbia University Medical Center NO DISCLOSURES Overview The hallmarks of the ideal test Benefits
More informationPARATHYROID NUCLEAR MEDICINE IMAGING REVIEW DISCLOSURES
PARATHYROID NUCLEAR MEDICINE IMAGING REVIEW Miguel Hernandez Pampaloni, M.D., Ph.D. Chief, Nuclear Medicine Assistant Professor of Radiology UCSF Department of Radiology and Biomedical Imaging DISCLOSURES
More informationPRIMARY HYPERPARATHYROIDISM
PRIMARY HYPERPARATHYROIDISM HYPERPARATHYROIDISM Inappropriate excess secretion of Parathyroid Hormone in Primary Hyperparathyroidism Appropriate Hypersecretion in Secondary Hyperparathyroidism PTH and
More informationhypercalcemia of malignancy hyperparathyroidism PHPT the most common cause of hypercalcemia in the outpatient setting the second most common cause
hyperparathyroidism A 68-year-old woman with documented osteoporosis has blood tests showing elevated serum calcium and parathyroid hormone (PTH) levels: 11.2 mg/dl (8.8 10.1 mg/dl) and 88 pg/ml (10-60),
More informationHPI joint pain/arthritis serum calcium 11.5 PTH 147pg/ml
HPI 45 yo female Increased calcium level during evaluation for joint pain/arthritis W/U showed serum calcium 11.5 and PTH 147pg/ml (Normal 11-67pg/ml) Otherwise asymptomatic PMH/PSH Arthritis Tonsillectomy
More informationIntraoperative parathyroid hormone level in parathyroidectomy: which patients benefit from it?
Zawawi et al. Journal of Otolaryngology - Head and Neck Surgery 2013, 42:56 ORIGINAL RESEARCH ARTICLE Open Access Intraoperative parathyroid hormone level in parathyroidectomy: which patients benefit from
More informationTHE PARATHYROID GLAND THEORY AND NUCLEAR MEDICINE PRACTICE
THE PARATHYROID GLAND THEORY AND NUCLEAR MEDICINE PRACTICE George N. Sfakianakis MD Professor of Radiology and Pediatrics Director, Division of Nuclear Medicine UM/JMMC Miami FL October 2009 ENDONCRINE
More informationOutline. SPECT/CT in Parathyroid Disease. Pathophysiology. Current guidelines. SPECT/CT the evidence. SPECT/CT in clinical scenarios
SPECT/CT in Parathyroid Disease Ann-Marie Quigley Nuclear Medicine Royal Free Hospital London Outline Pathophysiology Current guidelines SPECT/CT the evidence SPECT/CT in clinical scenarios MGD, Nodular
More informationMinimally invasive surgery for primary hyperparathyroidism with or without intraoperative parathyroid hormone monitoring
Endocrine Journal 2009, 57 Or i g i n a l Advance Publication doi: 10.1507/endocrj. K10E-196 Minimally invasive surgery for primary hyperparathyroidism with or without intraoperative parathyroid hormone
More informationOutline. Primary Hyperparathyriodism. SPECT/CT in Parathyroid Localisation. Ann-Marie Quigley Nuclear Medicine Royal Free Hospital London
SPECT/CT in Parathyroid Localisation Ann-Marie Quigley Nuclear Medicine Royal Free Hospital London Outline Pathophysiology Current guidelines SPECT/CT the evidence SPECT/CT in clinical scenarios MGD, Nodular
More informationORIGINAL ARTICLE. An Optimal Algorithm for Intraoperative Parathyroid Hormone Monitoring
ORIGINAL ARTICLE An Optimal Algorithm for Intraoperative Parathyroid Hormone Monitoring Melanie L. Richards, MD; Geoffrey B. Thompson, MD; David R. Farley, MD; Clive S. Grant, MD Background: A minimally
More informationClinical Medicine Insights: Endocrinology and Diabetes 2013:6
Open Access: Full open access to this and thousands of other papers at http://www.la-press.com. Clinical Medicine Insights: Endocrinology and Diabetes Surgery for Primary Hyperparathyroidism in Patients
More informationPreoperative Tc-99m-sestamibi (MIBI) scintigraphy and
Otolaryngology Head and Neck Surgery (2006) 134, 316-320 ORIGINAL RESEARCH In Vivo Characterisation of Parathyroid Lesions by Use of Gamma Probe: Comparison With Ex Vivo Count Method and Frozen Section
More informationSurgical treatment of primary hyperparathyroidism due to parathyroid tumor: A 15-year experience
ONCOLOGY LETTERS 12: 1989-1993, 2016 Surgical treatment of primary hyperparathyroidism due to parathyroid tumor: A 15-year experience LU FENG, XU ZHANG and SHAN TING LIU Department of Head and Neck Surgery,
More informationGeneral Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons
General Surgery Curriculum Royal Australasian College of Surgeons, General Surgeons Australia & New Zealand Association of General Surgeons MODULE TITLE: ENDOCRINE 5-May-2013 DEVELOPED BY: Jonathan Serpell
More informationHealth Sciences Centre, Team A, Dr. L. Bohacek (Endocrine Surgery) Medical Expert
Health Sciences Centre, Team A, Dr. L. Bohacek (Endocrine Surgery) Introduction Medical Expert This is a three month PGY 1-5 rotation in which residents gain exposure in the care and management of patients
More informationPrimary hyperparathyroidism (HPT) has an incidence of
Dual-Phase Tc-Sestamibi Imaging: Its Utility in Parathyroid Hyperplasia and Use of Immediate/ Delayed Image Ratios to Improve Diagnosis of Hyperparathyroidism Leonie Gordon, MD; William Burkhalter, MD;
More informationPrimary Hyperparathyroidism
November 2002 Primary Hyperparathyroidism Lori Coburn, Harvard Medical School Year III Hyperparathyroidism An increase in parathyroid hormone (PTH) production Divided into Primary, Secondary and Tertiary
More informationPreoperative Localization and Intraoperative Parathyroid Hormone Assay in Korean Patients with Primary Hyperparathyroidism
Original Article Endocrinol Metab 2014;29:464-469 http://dx.doi.org/10.3803/enm.2014.29.4.464 pissn 2093-596X eissn 2093-5978 Preoperative Localization and Intraoperative Parathyroid Hormone Assay in Korean
More informationPAPER. The Effectiveness of Radioguided Parathyroidectomy in Patients With Negative Technetium Tc 99m Sestamibi Scans
PAPER The Effectiveness of Radioguided Parathyroidectomy in Patients With Negative Technetium Tc 99m Sestamibi Scans Herbert Chen, MD; Rebecca S. Sippel, MD; Sarah Schaefer, NP Background: Many surgeons
More informationParathyroids, Small but Mighty Current Pathways to Early Diagnosis and Cure of Parathyroid Disease
Parathyroids, Small but Mighty Current Pathways to Early Diagnosis and Cure of Parathyroid Disease Mira Milas MD, FACS Professor of Surgery Director of Endocrine Surgery No conflicts of interest or financial
More informationNormal PTH Levels in Primary Hyperparathyroidism: Still the Same Disease?
Ann Surg Oncol (2011) 18:3437 3442 DOI 10.1245/s10434-011-1744-x ORIGINAL ARTICLE ENDOCRINE TUMORS Normal PTH Levels in Primary Hyperparathyroidism: Still the Same Disease? Amanda L. Amin, MD, Tracy S.
More informationUSEFULNESS OF INTRAOPERATIVE PARATHYROID HORMONE MONITORING DURING MINIMALLY INVASIVE VIDEO-ASSISTED PARATHYROIDECTOMY
USEFULNESS OF INTRAOPERATIVE PARATHYROID HORMONE MONITORING DURING MINIMALLY INVASIVE VIDEO-ASSISTED PARATHYROIDECTOMY Elisabetta Stenner elisabetta.stenner@asuits.sanita.fvg.it Introduction: primary hyperparathyroidism
More informationHyperparathyroidism: Operative Considerations. Financial Disclosures: None. Hyperparathyroidism. Hyperparathyroidism 11/10/2012
Hyperparathyroidism: Operative Considerations Financial Disclosures: None Steven J Wang, MD FACS Associate Professor Dept of Otolaryngology-Head and Neck Surgery University of California, San Francisco
More informationClinical Approach to Hypercalcemia For the Primary Care Provider
Clinical Approach to Hypercalcemia For the Primary Care Provider Christina Maser, MD FACS UCSF Fresno Department of Surgery, Endocrine Surgery 2/2/19 Objectives Recognition of pitfalls of diagnosis of
More informationParathyroid Imaging: Current Concepts. Maria Gule-Monroe, M.D. Nancy Perrier, M.D.
Parathyroid Imaging: Current Concepts Maria Gule-Monroe, M.D. Nancy Perrier, M.D. Disclosures None Objectives Ultrasound characteristics of parathyroid adenomas vs. lymph nodes 4D-CT evaluation of hyperparathyroidism
More informationParathyroid Glands: location, condition and value of imaging tests.
Parathyroid Glands: location, condition and value of imaging tests. Poster No.: C-2283 Congress: ECR 2015 Type: Educational Exhibit Authors: E. Elías Cabot, P. Segui, G. D. Tobar Murgueitio; Cordoba/ES
More informationHyperparathyroidism (primary): diagnosis, assessment and initial management
National Institute for Health and Care Excellence. Hyperparathyroidism (primary): diagnosis, assessment and initial management NICE guideline . October 2018 This guideline was developed by the
More informationThe current status of intraoperative ipth assay in surgery for primary hyperparathyroidism
Review Article The current status of intraoperative ipth assay in surgery for primary hyperparathyroidism Marcin Barczyński 1, Filip Gołkowski 2, Ireneusz Nawrot 3 1 Department of Endocrine Surgery, Third
More informationRADIOGUIDED PARATHYROIDECTOMY IS SUCCESSFUL IN 98.7% OF SELECTED PATIENTS
Original Article RADIOGUIDED PARATHYROIDECTOMY IS SUCCESSFUL IN 98.7% OF SELECTED PATIENTS Charles D. Livingston, MD, FACS ABSTRACT Objective: To examine an individualized approach to patients with primary
More informationThyroid Ultrasound for the Endocrine Surgeon: A Valuable Clinical Tool that Enhances Diagnostic and Therapeutic Outcomes
Thyroid Ultrasound for the Endocrine Surgeon: A Valuable Clinical Tool that Enhances Diagnostic and Therapeutic Outcomes Allan Siperstein MD The Cleveland Clinic Audience Quiz Taken ultrasound course Perform
More informationSouthern Derbyshire Shared Care Pathology Guidelines. Primary Hyperparathyroidism
Southern Derbyshire Shared Care Pathology Guidelines Primary Hyperparathyroidism Please use this Guideline in Conjunction with the Hypercalcaemia Guideline Definition Driven by hyperfunction of one or
More informationSix hundred fifty-six consecutive explorations for primary hyperparathyroidism Udelsman R
Six hundred fifty-six consecutive explorations for primary hyperparathyroidism Udelsman R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS
More informationEffect of open minimally invasive parathyroidectomy in the management of primary hyperparathyroidism
International Surgery Journal Kumar SR et al. Int Surg J. 2017 Nov;4(11):3660-3664 http://www.ijsurgery.com pissn 2349-3305 eissn 2349-2902 Original Research Article DOI: http://dx.doi.org/10.18203/2349-2902.isj20174881
More informationComparison Of Sestamibi Scintigraphy And Ultrasonography In Preoperative Localization Of Primary Hyperparathyroidism
ISPUB.COM The Internet Journal of Surgery Volume 16 Number 1 Comparison Of Sestamibi Scintigraphy And Ultrasonography In Preoperative Localization Of Primary S Nasiri, A Sorush, A Hashemi, F Mehrkhani,
More informationThe Leeds Teaching Hospitals NHS Trust Primary hyperparathyroidism - Parathyroidectomy
n The Leeds Teaching Hospitals NHS Trust Primary hyperparathyroidism - Parathyroidectomy Information for patients This leaflet provides information on having a parathyroidectomy, reasons for the procedure
More informationParathyroid Imaging. A Guide to Parathyroid Surgery
Parathyroid Imaging A Guide to Parathyroid Surgery Primary Hyperparathyroidism (PHPT) 3 rd most common endocrine disorder after diabetes and hyperthyroidism Prevalence in women 2% Often discovered in asymptomatic
More informationCURRENTLY THERE is considerable discussion about
0013-7227/02/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 87(3):1024 1029 Printed in U.S.A. Copyright 2002 by The Endocrine Society Parathyroid Surgery: Separating Promise from Reality NANCY
More informationPotential conflicts of interest: None
Hyperparathyroidism When to Suspect, How to Diagnose, When and How to Intervene November 6, 2013 Johanna A. Pallotta, MD, FACP, FACE Potential conflicts of interest: None Johanna A. Pallotta, MD Outline
More informationTitle:Relationship between parathyroid mass and parathyroid hormone level in hemodialysis patients with secondary hyperparathyroidism
Author's response to reviews Title:Relationship between parathyroid mass and parathyroid hormone level in hemodialysis patients with secondary hyperparathyroidism Authors: Li Fang (fangli@njmu.edu.cn)
More informationSurgical Outcome of Patients with Hyperparathyroidism in a Non-Specialist Surgical Ward
ORIGINAL ARTICLE Surgical Outcome of Patients with Hyperparathyroidism in a Non-Specialist Surgical Ward A C Roslani, MS*, N L W Chang** *Department of Surgery, Faculty of Medicine, University of Malaya,
More informationPatient Information Leaflet P1
Patient Information Leaflet P1 Parathyroid Operations in Adults What are the Parathyroid glands and what do they do? Usually, you have four parathyroid glands. These are located between the thyroid gland
More informationNephrology and Surgical Department Parathyroid Surgery in Adults
Nephrology and Surgical Department Parathyroid Surgery in Adults This leaflet explains surgery to treat Primary Hyperparathyroidism. It will help you to understand the operation and the care that you will
More informationMinimally invasive parathyroidectomy with or without intraoperative parathyroid hormone for primary hyperparathyroidism
ORIGINAL ARTICLE pissn 2288-6575 eissn 2288-6796 http://dx.doi.org/10.4174/astr.2015.89.3.111 Annals of Surgical Treatment and Research Minimally invasive parathyroidectomy with or without intraoperative
More informationRe-explorative Parathyroid Surgery for Persistent and Recurrent Primary Hyperparathyroidism
10.5005/jp-journals-10002-1070 ORIGINAL ARTICLE WJOES Re-explorative Parathyroid Surgery for Persistent and Recurrent Primary Hyperparathyroidism Rachel L O Connell, Karolina Afors, Martin H Thomas Ashford
More informationIMPACT OF CONCOMITANT THYROID PATHOLOGY ON PREOPERATIVE WORKUP FOR PRIMARY HYPERPARATHYROIDISM
January 28, 2009 EUROPEAN JOURNAL OF MEDICAL RESEARCH 37 Eur J Med Res (2009) 14: 37-41 I. Holzapfel Publishers 2009 IMPACT OF CONCOMITANT THYROID PATHOLOGY ON PREOPERATIVE WORKUP FOR PRIMARY HYPERPARATHYROIDISM
More informationPerioperative parathormone assessment during surgery for primary hyperparathyroidism;
08. hoofdstuk 08 23-07-2001 09:52 Pagina 79 Perioperative parathormone assessment during surgery for primary hyperparathyroidism; Comparison of four techniques 8 Submitted for publication as Smit PC, Borel
More informationAbhijit Thakur Æ Frederic Sebag Æ Eveline Slotema Æ Giuseppe Ippolito Æ David Taïeb Æ Jean François Henry
World J Surg (2009) 33:1219 1223 DOI 10.1007/s00268-009-0029-z Significance of Biochemical Parameters in Differentiating Uniglandular from Multiglandular Disease and Limiting Use of Intraoperative Parathormone
More informationPAPER. An Algorithm to Maximize Use of Minimally Invasive Parathyroidectomy
PAPER An Algorithm to Maximize Use of Minimally Invasive Parathyroidectomy Roderick M. Quiros, MD; Joseph Alioto, BA; Scott M. Wilhelm, MD; Amjad Ali, MD; Richard A. Prinz, MD Hypothesis: Minimally invasive
More informationINDEX. Note: Page numbers of issue and article titles are in boldface type. cell carcinoma. ENDOCRINE SURGERY
ENDOCRINE SURGERY INDEX Note: Page numbers of issue and article titles are in boldface type. Adenylate cyclase, in signal transduction 425-426 Adrenal incidentalomas, 499-509 imaging of, 502-504 in patients
More informationA Move Towards Focused Parathyroidectomy in BSMMU Even Under Local Anesthesia
40 A Move Towards Focused Parathyroidectomy in BSMMU Even Under Local Anesthesia Jawhar Lal Singha 1, Saifuddin Ahmed 2, AHM Towhidul Alam 3, Nasim Sobhan Khondokar 4, Syed Serajul Karim 5 1 MS Student,
More informationTHE ASSOCIATION OF PRIMARY HYPERPARATHYROIDISM WITH DISORDERS OF THE THYROID GLAND AND CARPENTRY OUR EXPERIENCE
24 MEDICINSKI GLASNIK / str. 24-30 Snežana Marinković, Nenad Laketić 1 THE ASSOCIATION OF PRIMARY HYPERPARATHYROIDISM WITH DISORDERS OF THE THYROID GLAND AND CARPENTRY OUR EXPERIENCE Introduction Primary
More informationThyroid & Parathyroid glands Ultrasound evaluation.
Thyroid & Parathyroid glands Ultrasound evaluation. www.headandneckultrasound.co.uk Rhodri M Evans Incidence 70 Thyroid Nodules 30 Palpation 50 Age 100 Incidence 70 Thyroid Nodules US/Autopsy 30 Palpation
More informationIndex. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A ACC. See Adrenal cortical carcinoma. Acromegaly and the pituitary gland, 551 Acute suppurative thyroiditis, 405, 406 Addison, Thomas and
More informationReoperative central neck surgery
Reoperative central neck surgery R. Pandev, I. Tersiev, M. Belitova, A. Kouizi, D. Damyanov University Clinic of Surgery, Section Endocrine Surgery University Hospital Queen Johanna ISUL Medical University
More informationSPECT/CT in Endocrine Diseases and Dosimetry
SPECT/CT in Endocrine Diseases and Dosimetry Heather A. Jacene, MD Division of Nuclear Medicine Russell H. Morgan Dept. of Radiology and Radiological Science Johns Hopkins University Baltimore, MD Disclosures
More informationIntraoperative Parathyroid Hormone Monitoring Corroborates the Success of Parathyroidectomy in Children
J Clin Res Pediatr Endocrinol 2014;6(3):158-162 DO I: 10.4274/jcrpe.1401 Original Article Intraoperative Hormone Monitoring Corroborates the Success of ectomy in Children Ahmet Çelik1, Emre Divarcı1, Zafer
More informationCKD: Bone Mineral Metabolism. Peter Birks, Nephrology Fellow
CKD: Bone Mineral Metabolism Peter Birks, Nephrology Fellow CKD - KDIGO Definition and Classification of CKD CKD: abnormalities of kidney structure/function for > 3 months with health implications 1 marker
More informationPeroperative PTH testing:
07. hoofdstuk 07 23-07-2001 09:52 Pagina 69 Peroperative PTH testing: confirmation of successful surgical treatment of primary hyperparathyroidism 7 Smit PC, Thijssen JHH, Borel Rinkes IHM, van Vroonhoven
More informationParathyroidectomy. Surgery for Parathyroid Problems
Parathyroidectomy Surgery for Parathyroid Problems Why You Need Parathyroid Surgery Has your doctor just recommended that you have parathyroid surgery? If so, you likely have many questions. What are the
More informationDetecting Parathyroid Disease
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/detecting-parathyroid-disease/3078/
More informationE. Ypsilantis, 1 H. Charfare, 2 andw.s.wassif Introduction
International Endocrinology Volume 2010, Article ID 178671, 5 pages doi:10.1155/2010/178671 Clinical Study Intraoperative PTH Assay during Minimally Invasive Parathyroidectomy May Be Helpful in the Detection
More informationBone and Renal Stone Disease in Patients Operated for Primary Hyperparathyroidism in Pakistan: Is the Pattern of Disease different from the West?
ecommons@aku Section of Urology Department of Surgery August 1999 Bone and Renal Stone Disease in Patients Operated for Primary Hyperparathyroidism in Pakistan: Is the Pattern of Disease different from
More informationPAPER. John I. Lew, MD; Mariela Rivera, MD; George L. Irvin III, MD; Carmen C. Solorzano, MD
PAPER Operative Failure in the Era of Focused Parathyroidectomy A Contemporary Series of 845 Patients John I. Lew, MD; Mariela Rivera, MD; George L. Irvin III, MD; Carmen C. Solorzano, MD Hypothesis: Focused
More informationORIGINAL ARTICLE. Appearance of Ectopic Undescended Inferior Parathyroid Adenomas on Technetium Tc 99m Sestamibi Scintigraphy
ORIGINAL ARTICLE Appearance of Ectopic Undescended Inferior Parathyroid Adenomas on Technetium Tc 99m Sestamibi Scintigraphy A Lesson From Reoperative Parathyroidectomy David Axelrod, MD; James C. Sisson,
More informationHybrid Imaging SPECT/CT PET/CT PET/MRI. SNMMI Southwest Chapter Aaron C. Jessop, MD
Hybrid Imaging SPECT/CT PET/CT PET/MRI SNMMI Southwest Chapter 2014 Aaron C. Jessop, MD Assistant Professor, Department of Nuclear Medicine UT MD Anderson Cancer Center, Houston, Texas Complimentary role
More information4/20/2015. The Neck xt Exploration: Intraoperative Parathyroid Hormone (IOPTH) Testing During Surgical Parathyroidectomy. Learning Objectives
The Neck xt Exploration: Intraoperative Parathyroid Hormone (IOPTH) Testing During Surgical Parathyroidectomy Nichole Korpi-Steiner, PhD, DABCC, FACB University of North Carolina Chapel Hill, NC Learning
More informationThyroid nodules 3/22/2011. Most thyroid nodules are benign. Thyroid nodules: differential diagnosis
Most thyroid nodules are benign Thyroid nodules Postgraduate Course in General Surgery thyroid nodules occur in 77% of the world s population palpable thyroid nodules occur in about 5% of women and 1%
More informationThe Leeds Teaching Hospitals NHS Trust Renal hyperparathyroidism - Parathyroidectomy
n The Leeds Teaching Hospitals NHS Trust Renal hyperparathyroidism - Parathyroidectomy Information for patients This leaflet provides information about renal hyperparathyroidism and having a parathyroidectomy,
More informationRadiographic Appearance Of Primary Hyperparathyroidism With Atypical Parathyroid Adenoma
ISPUB.COM The Internet Journal of Internal Medicine Volume 6 Number 2 Radiographic Appearance Of Primary Hyperparathyroidism With Atypical Parathyroid Adenoma P George, N Philip, B Pawar Citation P George,
More informationDirect, minimally invasive adenomectomy for primary hyperparathyroidism:
04. hoofdstuk 04 23-07-2001 10:04 Pagina 23 Direct, minimally invasive adenomectomy for primary hyperparathyroidism: An alternative to conventional neck exploration? 4 Smit PC, Borel Rinkes IHM, van Dalen
More informationORIGINAL ARTICLE. A Cost Justification for Routine Preoperative Localization With Technetium Tc 99m Sestamibi Scan
The Ectopic Parathyroid Adenoma A Cost Justification for Routine Preoperative Localization With Technetium Tc 99m Sestamibi Scan Robert A. Sofferman, MD; Muriel H. Nathan, MD, PhD ORIGINAL ARTICLE Objectives:
More informationIndex. Surg Oncol Clin N Am 16 (2007) Note: Page numbers of article titles are in boldface type.
Surg Oncol Clin N Am 16 (2007) 465 469 Index Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, preoperative for gastric cancer, staging and, 339 B Breast cancer, metabolic
More informationHyperparathyroidism. When to Suspect, How to Diagnose, When and How to Intervene. Johanna A. Pallotta, MD, FACP, FACE
Hyperparathyroidism When to Suspect, How to Diagnose, When and How to Intervene Johanna A. Pallotta, MD, FACP, FACE Potential conflicts of interest: None Johanna A. Pallotta, MD Outline Definition of hyperparathyroidism
More informationEndocrine University 2016 AACE-ACE-MAYO CLINIC
Endocrine University 2016 AACE-ACE-MAYO CLINIC Dev Abraham MD, MRCP (UK), ECNU Professor of Medicine (clinical), Division of Endocrinology Adjunct Professor of Surgery and Pathology Medical Director, Utah
More informationM. C. Neves, 1 M. N. Ohe, 2 M. Rosano, 1 M. Abrahão, 1 O. Cervantes, 1 M. Lazaretti-Castro, 2 J. G. H. Vieira, 2 I. S. Kunii, 2 andr.o.
Osteoporosis Volume 2012, Article ID 914214, 6 pages doi:10.1155/2012/914214 Clinical Study A 10-Year Experience in Intraoperative Parathyroid Hormone Measurements for Primary Hyperparathyroidism: A Prospective
More informationThis PDF is available for free download from a site hosted by Medknow Publications
Original Article Role of radionuclide scintigraphy in the detection of parathyroid adenoma Singh N, Krishna BA Department of Nuclear Medicine, P. D. Hinduja National Hospital and MRC, Mumbai, India Correspondence
More informationResult Navigator. Positive Test Result: MEN1. After a positive test result, there can be many questions about what to do next. Navigate Your Results
Result Navigator Positive Test Result: MEN1 Positive test results identify a change, or misspelling, of DNA that is known or predicted to cause an increased risk for cancer. DNA is the blueprint of life
More informationParathyroid Disease Scenarios for the Practicing Clinician. Vijaya Chockalingam MD Faculty Endocrinologist Banner University Medical Center- Phoenix
Parathyroid Disease Scenarios for the Practicing Clinician Vijaya Chockalingam MD Faculty Endocrinologist Banner University Medical Center- Phoenix Clinical Scenario-1 73 year man (BK) with hypercalcemia
More informationResult Navigator. Positive Test Result: RET. After a positive test result, there can be many questions about what to do next. Navigate Your Results
Result Navigator Positive Test Result: RET Positive test results identify a change, or misspelling, of DNA that is known or predicted to cause an increased risk for cancer. DNA is the blueprint of life
More informationCoexistence of parathyroid adenoma and papillary thyroid carcinoma. Yong Sang Lee, Kee-Hyun Nam, Woong Youn Chung, Hang-Seok Chang, Cheong Soo Park
J Korean Surg Soc 2011;81:316-320 http://dx.doi.org/10.4174/jkss.2011.81.5.316 ORIGINAL ARTICLE JKSS Journal of the Korean Surgical Society pissn 2233-7903 ㆍ eissn 2093-0488 Coexistence of parathyroid
More informationPrimary Hyperparathyroidism
Primary Hyperparathyroidism Copyright Copyright 2019 2019 American American Associa7on Associa7on of Clinical of Clinical Endocrinologists Endocrinologists 1 Primary Hyperparathyroidism In primary hyperparathyroidism
More informationWhen the level of calcium in the blood falls too low, the parathyroid glands secrete just enough PTH to restore the blood calcium level.
Hyperparathyroidism Primary hyperparathyroidism is a disorder of the parathyroid glands, also called parathyroids. Primary means this disorder originates in the parathyroids: One or more enlarged, overactive
More informationORIGINAL ARTICLE. Outcome Measures and Scar Aesthetics in Minimally Invasive Video-Assisted Parathyroidectomy
ORIGINAL ARTICLE Outcome Measures and Scar Aesthetics in Minimally Invasive Video-Assisted Parathyroidectomy Paula Casserly, MRCSI, MCh; Rachel Kirby, MRCSI; Conrad Timon, FRCS-ORL, MD Objectives: To compare
More informationParathyrin (PTH), also known as parathyroid hormone
Strategies for Laboratory and Patient Management Intraoperative Testing for Parathyroid Hormone A Comprehensive Review of the Use of the Assay and the Relevant Literature Alexis Byrne Carter, MD; Peter
More information