The utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidism

Simple item page
dc.contributor.authorLim, Ming Sheng
dc.contributor.authorJinih, Marcel
dc.contributor.authorNgai, C. H.
dc.contributor.authorFoley, Niamh M.
dc.contributor.authorRedmond, H. Paul
dc.date.accessioned2018-07-30T10:30:33Z
dc.date.available2018-07-30T10:30:33Z
dc.date.issued2017
dc.description.abstractINTRODUCTION: Parathyroidectomy is the definitive treatment for primary hyperparathyroidism but the intraoperative identification of adenomas is challenging. The aim of this study was to evaluate the utility of a radionuclide probe (RNP) in addition to intraoperative parathyroid hormone (IOPTH) measurement as an intraoperative diagnostic adjunct in patients undergoing parathyroidectomy for primary hyperparathyroidism. METHODS: This was a retrospective cohort study of patients treated between 2004 and 2015 in a university affiliated teaching hospital. Patients were grouped into those with RNP use (RNP+) and those without (RNP-). The primary outcome measure was rate of operative failure, which included false positives. The diagnostic sensitivity and positive predictive value of both RNP and IOPTH were also evaluated. RESULTS A total of 298 patients were included in the study, 127 (42.6%) being in the RNP+ group and 171 (57.4%) in the RNP- group. The false positive rate for the RNP+ patients was 1.6% compared with 9.4% for RNP- patients (p= 0.006, hazard ratio [HR]: 6.45). The rates of operative failure were 6.3% and 11.7% respectively (p= 0.159, HR: 1.97). RNP use had a sensitivity of 92.0% and a positive predictive value of 98.3% compared with 78.6% and 95.2% respectively for IOPTH monitoring. CONCLUSIONS: RNP use is associated with fewer false positives and reduced operative failure than IOPTH measurement. It also has a higher sensitivity and positive predictive value. RNP use is recommended in centres that have the required facilities.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationLim, M. S., Jinih, M., Ngai, C. H., Foley, N. M. and Redmond, H. P. (2017) 'The utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidism', Annals of the Royal College of Surgeons of England, 99(5), pp. 369-372. doi: 10.1308/rcsann.2017.0016en
dc.identifier.doi10.1308/rcsann.2017.0016
dc.identifier.endpage372
dc.identifier.issn0035-8843
dc.identifier.issued5
dc.identifier.journaltitleAnnals of the Royal College of Surgeons of Englanden
dc.identifier.startpage369
dc.identifier.urihttps://hdl.handle.net/10468/6527
dc.identifier.volume99
dc.language.isoenen
dc.publisherRoyal College of Surgeons of Englanden
dc.relation.urihttps://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2017.0016
dc.rights© 2015, The Royal College of Surgeons of Englanden
dc.subjectParathyroidectomyen
dc.subjectParathyroid neoplasmen
dc.subjectIntraoperative careen
dc.subjectSensitivityen
dc.titleThe utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidismen
dc.typeArticle (peer-reviewed)en
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
The utility of the radionuclide probe in parathyroidectomy.pdf
Size:
148.15 KB
Format:
Adobe Portable Document Format
Description:
Published Version
Download
Collections
Surgery - Journal Articles