Noninvasive localization of parathyroid adenomas: A comparison of X-ray computerized tomography, ultrasound, scintigraphy and MRI

William A. Erdman, Neil A. Breslau, Jeffrey C. Weinreb, Paul Weatherall, Hartono Setiawan, Rebecca Harrell, William Snyder

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Thirty-two (32) patients with primary hyperparathyroidism (17 with prior localization surgery, 15 without) were studied by a combination of computed tomography (CT), ultrasound (US), nuclear medicine (NM), and magnetic resonance imaging (MRI) for parathyroid adenoma localization. The sensitivity and true-positive ratio of each imaging technique and various combinations of techniques were evaluated. Of the 28 proven parathyroid adenomas (27 by surgery, 1 by digital subtraction angiography), 24 were imaged by two techniques, 19 by three techniques, and 10 by all four imaging techniques. The sensitivities were NM (65%), CT (76%), US (77%), and MRI (81%). The differences between true-positive ratios of 82%, 64%, 71%, and 77%, respectively, were not statistically significant. If multiple techniques were considered as a single test (i.e., a positive localization requires two or more tests to be positive at the same location), then sensitivity for a two-study combination was 79% and true-positive ratio 86%. Three techniques showed a sensitivity of 63% and a true-positive ratio of 92%, four modalities 40% and 100%, respectively. There was no significant difference in the various combinations of techniques employed (e.g., CT and US, US and MR, NM and MR, etc.). Thus, there appears to be an advantage in performing multiple techniques (regardless of which combination is selected) until two tests are positive at the same location.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
JournalMagnetic Resonance Imaging
Volume7
Issue number2
DOIs
StatePublished - 1989

Keywords

  • Computerized tomography
  • Magnetic resonance
  • Parathyroid neoplasms
  • Scintigraphy
  • Ultrasound

ASJC Scopus subject areas

  • Biophysics
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging

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