Yıl: 2019 Cilt: 41 Sayı: 1 Sayfa Aralığı: 85 - 90 Metin Dili: İngilizce DOI: 10.5152/etd.2018.18147 İndeks Tarihi: 27-01-2020

Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?

Öz:
Objective: Hyperparathyroidism (HPT) is a frequent endocrine disorder that progresses with an increase in the parathormone (PTH) synthesis and secretion from the chief cells in one or more glands. The common methods used in the imagingof parathyroid adenomas are the ultrasonography and Tc-99m sestamibi scintigraphy (MIBI) scintigraphy. We aimed toinvestigate the determining characteristics and availability of the MIBI scintigraphy technique in detecting eutopic and ectopiclocalized parathyroid adenomas.Materials and Methods: This is a retrospective study. A total of 59 patients diagnosed with primary HPT between 2002and 2010 using parathyroid scintigraphy with Tc99m MIBI imaging and dual-phase dual-isotope technique, which wasreported as parathyroid adenoma, were enrolled into this study. To determine the radiopharmaceutic retention, an earlyparathyroid-to-thyroid ratio (early PT/T), late parathyroid-to-thyroid ratio (late PT/T), early-to-late ratio (E/L), and the retention index (RI) were calculated.Results: The lesions were divided into two groups: ectopic (n=28) and eutopic (n=37). When biochemical parameters werecompared, there was not any statistically significant difference in the physiological parameters excluding the PTH levels. Wedetermined that the level of PTH is the only biochemical parameter that is directly associated with the positivity of MIBI.Moreover, our findings revealed that the E/L ratio is negatively correlated with Ca+2 and P, while the RI ratio exhibited apositive association with Ca+2 and P in the ectopic group.Conclusion: We concluded that the MIBI is currently the best imaging method to diagnose parathyroid adenomas. Theideal imaging protocol should include a combination of a single photon emission computerized tomography study that is notprolonged over 1 h with an early and late planar (15 min and 2 h, respectively) imaging.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Ruda JM, Hollenbeak C, Stack BC Jr. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg 2005; 132(3): 359–72.
  • Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, et al. Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99(10): 3561–9. [CrossRef]
  • Noureldine SI, Gooi Z, Tufano RP. Minimally invasive parathyroid surgery. Gland Surg 2015; 4(5): 410–9.
  • Nafisi Moghadam R, Amlelshahbaz AP, Namiranian N, SobhanArdekani M, Emami-Meybodi M, Dehghan A, et al. Comparative Diagnostic Performance of Ultrasonography and 99mTc-Sestamibi Scintigraphy for Parathyroid Adenoma in Primary Hyperparathyroidism; Systematic Review and Meta- Analysis. Asian Pac J Cancer Prev 2017; 18(12): 3195–200.
  • Liddy S, Worsley D, Torreggiani W, Feeney J. Preoperative Imaging in Primary Hyperparathyroidism: Literature Review and Recommendations. Can Assoc Radiol J 2017; 68(1): 47–55. [CrossRef]
  • Mihai R, Gleeson F, Buley ID, Roskell DE, Sadler GP. Negative imaging studies for primary hyperparathyroidism are unavoidable: correlation of sestamibi and high-resolution ultrasound scanning with histological analysis in 150 patients. World J Surg 2006; 30(5): 697–704.
  • Varoglu E, Bayraktar R, Argon M, Atasever T, Celen Z, Kabasakal L, et al. Turkish Society of Nuclear Medicine Endocrinology and Radyonuclide Treatment Task Group Guideline for Parathyroid Scintigraphy. Turk J Nucl Med 2001; 10(Supp): 23–9.
  • Hindié E, Ugur O, Fuster D, O’Doherty M, Grassetto G, Ureña P, et al; Parathyroid Task Group of the EANM. 2009 EANM parathyroid guidelines. Eur J Nucl Med Mol Imaging 2009; 36(7): 1201–16.
  • Grubbs EG, Edeiken BS, Gule MK, Monroe BJ, Kim E, Vu T, et al. Preoperative Parathyroid Imaging for the Endocrine Surgeon. In: Khan AA, Clark OH, editors. Handbook of Parathyroid Diseases: A CaseBased Practical Guide. New York: Springer Science; 2012. p. 19–40.
  • Qiu ZL, Wu B, Shen CT, Zhu RS, Luo QY. Dual-phase (99m)Tc-MIBI scintigraphy with delayed neck and thorax SPECT/CT and bone scintigraphy in patients with primary hyperparathyroidism: correlation with clinical or pathological variables. Ann Nucl Med 2014; 28(8): 725–35. [CrossRef]
  • Ozkan ZG, Unal SN, Kuyumcu S, Sanli Y, Gecer MF, Ozcinar B, et al. Clinical Utility of Tc-99m MIBI SPECT/CT for Preoperative Localization of Parathyroid Lesions. Indian J Surg 2017; 79(4): 312–8.
  • Oksüz MO, Dittmann H, Wicke C, Müssig K, Bares R, Pfannenberg C, et al. Accuracy of parathyroid imaging: a comparison of planar scintigraphy, SPECT, SPECT-CT, and C-11 methionine PET for the detection of parathyroid adenomas and glandular hyperplasia. Diagn Interv Radiol 2011; 17(4): 297–307. [CrossRef]
  • Beheshti M, Hehenwarter L, Paymani Z, Rendl G, Imamovic L, Rettenbacher R, et al. 18F-Fluorocholine PET/CT in the assessment of primary hyperparathyroidism compared with 99mTc-MIBI or 99mTctetrofosmin SPECT/CT: a prospective dual-centre study in 100 patients. Eur J Nucl Med Mol Imaging 2018; 45(10): 1762–71.
  • Kunstman JW, Kirsch JD, Mahajan A, Udelsman R. Parathyroid Localization and Implications for Clinical Management. J Clin Endocrinol Metab 2013; 98(3): 902–12. [CrossRef]
  • Listewnik MH, Piwowarska-Bilska H, Kurantowicz M, Ostrowski M, Borowiecki A, Safranow K, et al. Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study. Nucl Med Rev Cent East Eur 2017; 20(1): 18–24. [CrossRef]
  • Gupta Y, Ahmed R, Happerfield L, Pinder SE, Balan KK, Wishart GC. P-glycoprotein expression is associated with sestamibi washout in primary hyperparathyroidism. Br J Surg 2007; 94(12): 1491–5.
  • Pons F, Torregrosa JV, Fuster D. Biological factors influencing parathyroid localization. Nucl Med Commun 2003; 24(2): 121–4. [CrossRef]
  • Koberstein W, Fung C, Romaniuk K, Abele JT. Accuracy of Dual Phase Single-Photon Emission Computed Tomography/Computed Tomography in Primary Hyperparathyroidism: Correlation With Serum Parathyroid Hormone Levels. Can Assoc Radiol J 2016; 67(2): 115–21. [CrossRef]
  • Hung GU, Wang SJ, Lin WY. Tc-99m MIBI parathyroid scintigraphy and intact parathyroid hormone levels in hyperparathyroidism. Clin Nucl Med 2003; 28(3): 180–5. [CrossRef]
  • Siegel A, Alvarado M, Barth RJ Jr, Brady M, Lewis J. Parameters in the Prediction of the Sensitivity of Parathyroid Scanning. Clin Nucl Med 2006; 31(11): 679–82. [CrossRef]
  • Melloul M, Paz A, Koren R, Cytron S, Feinmesser R, Gal R. 99mTcMIBI scintigraphy of parathyroid adenomas and its relation to tumour size and oxyphil cell abundance. Eur J Nucl Med 2001; 28(2): 209–13.
  • Erbil Y, Barbaros U, Tükenmez M, Işsever H, Salmaslioğlu A, Adalet I, et al. Impact of adenoma weight and ectopic location of parathyroid adenoma on localization study results. World J Surg 2008; 32(4): 566–71. [CrossRef]
  • Cermik TF, Puyan FO, Sezer A, Firat MF, Berkarda S. Relation between Tc-99m sestamibi uptake and biological factors in hyperparathyroidism. Ann Nucl Med 2005; 19(5): 387–92. [CrossRef]
  • Ciappuccini R, Morera J, Pascal P, Rame JP, Heutte N, Aide N, et al. Dual-phase 99mTc sestamibi scintigraphy with neck and thorax SPECT/CT in primary hyperparathyroidism: a single-institution experience. Clin Nucl Med 2012; 37(3): 223–8. [CrossRef]
  • Richert L, Trombetti A, Herrmann FR, Triponez F, Meier C, Robert JH, et al. Age and gender distribution of primary hyperparathyroidism and incidence of surgical treatment in a European country with a particularly high life expectancy. Swiss Med Wkly 2009; 139(27-28): 400–4.
APA KORKMAZ Ü, SARIKAYA A (2019). Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. , 85 - 90. 10.5152/etd.2018.18147
Chicago KORKMAZ Ülkü,SARIKAYA Ali Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. (2019): 85 - 90. 10.5152/etd.2018.18147
MLA KORKMAZ Ülkü,SARIKAYA Ali Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. , 2019, ss.85 - 90. 10.5152/etd.2018.18147
AMA KORKMAZ Ü,SARIKAYA A Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. . 2019; 85 - 90. 10.5152/etd.2018.18147
Vancouver KORKMAZ Ü,SARIKAYA A Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. . 2019; 85 - 90. 10.5152/etd.2018.18147
IEEE KORKMAZ Ü,SARIKAYA A "Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?." , ss.85 - 90, 2019. 10.5152/etd.2018.18147
ISNAD KORKMAZ, Ülkü - SARIKAYA, Ali. "Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?". (2019), 85-90. https://doi.org/10.5152/etd.2018.18147
APA KORKMAZ Ü, SARIKAYA A (2019). Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. Erciyes Medical Journal, 41(1), 85 - 90. 10.5152/etd.2018.18147
Chicago KORKMAZ Ülkü,SARIKAYA Ali Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. Erciyes Medical Journal 41, no.1 (2019): 85 - 90. 10.5152/etd.2018.18147
MLA KORKMAZ Ülkü,SARIKAYA Ali Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. Erciyes Medical Journal, vol.41, no.1, 2019, ss.85 - 90. 10.5152/etd.2018.18147
AMA KORKMAZ Ü,SARIKAYA A Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. Erciyes Medical Journal. 2019; 41(1): 85 - 90. 10.5152/etd.2018.18147
Vancouver KORKMAZ Ü,SARIKAYA A Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?. Erciyes Medical Journal. 2019; 41(1): 85 - 90. 10.5152/etd.2018.18147
IEEE KORKMAZ Ü,SARIKAYA A "Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?." Erciyes Medical Journal, 41, ss.85 - 90, 2019. 10.5152/etd.2018.18147
ISNAD KORKMAZ, Ülkü - SARIKAYA, Ali. "Ectopic and Eutopic Located Parathyroid Lesions: Do They Behave Differently? How Can We Monitor Them? What Should We Look for?". Erciyes Medical Journal 41/1 (2019), 85-90. https://doi.org/10.5152/etd.2018.18147