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Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Acta+Radiol+Open 2018 ; 7 (2): ä Nephropedia Template TP
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Selective venous sampling supports localization of adenoma in primary hyperparathyroidism #MMPMID29511573
Ikuno M; Yamada T; Shinjo Y; Morimoto T; Kumano R; Yagihashi K; Katabami T; Nakajima Y
Acta Radiol Open 2018[Feb]; 7 (2): ä PMID29511573show ga
Background: Selective venous sampling (SVS) is an invasive localization study for persistent or recurrent hyperparathyroidism. Purpose: To assess the role of SVS in addition to non-invasive imaging for primary hyperparathyroidism (pHPT). Material and Methods: This study was approved by the institutional review board and included 14 patients who underwent SVS and subsequent parathyroidectomy between January 2014 and April 2017 following a clinical diagnosis of pHPT. All patients underwent pre-SVS non-invasive imaging, including ultrasound, computed tomography (CT), and 99mTc-MIBI scintigraphy, and sensitivity was assessed using the operative and pathological findings. Results: In all but one case, a single parathyroid adenoma was responsible for the pHPT; the remaining case exhibited a chemical response following surgical removal of parathyroid tissue. The sensitivity (%) for ultrasound, CT, 99mTc-MIBI scintigraphy, and SVS was 76.9, 84.6, 69.2, and 76.9, respectively. SVS yielded positive results in four patients with discordant results and one patient with non-detectable results on imaging. In seven patients, a significant increase in the intact parathyroid hormone level was recognized only in the thyroid veins. The procedure time was in the range of 52?183?min (median?=?89.5?min). Conclusion: The addition of SVS to a non-invasive imaging study would be helpful to locate the responsible lesion of pHPT with discordant or non-detectable results on imaging for initial surgical treatment as well.