Individual and combined sensitivity of ultrasound and 99mTc-MIBI in localizing parathyroid adenoma; Our experience

Objectives To calculate individual and combined sensitivity of ultrasound and 99mTc-MIBI scan in localizing parathyroid adenoma in patients diagnosed with primary hyperparathyroidism Materials and methods This is a single institute retrospective study analysing the results of 45 patients who underwent parathyroid adenoma excision in study specified duration . Patients details were reviewed using electronic medical record system and imaging findings were compared with final post op histopathology to calculate sensitivity of high resolution ultrasound and MIBI scan in localizing parathyroid adenoma . Cases using combined modalities were analysed to calculate combined sensitivity . Results Our results show that ultrasound has a sensitivity of 91.85 % while MIBI scan has sensitivity of 81.5 % in diagnosing parathyroid adenoma in patients with primary hyperparathyroidism and combined sensitivity for both modalities is 94.28 % . Conclusion In expert hands ultrasound is more sensitive than MIBI scan in localizing parathyroid adenoma . However , combining both modalities can even increase sensitivity to 94.28 percent . Other modalities like PET Choline scan and parathyroid wash out show promising results with increased sensitivity and specificity but need further studies to analyse these results.