Clinicopathological variables that correlate with sestamibi positivity in uniglandular parathyroid disease: a retrospective analysis of 378 parathyroid adenomas


Durmuş Çalışkan E., Atmaca A., Kefeli M., Mete O., Canbaz Tosun F., Baycelebi D., ...Daha Fazla

ANNALS OF NUCLEAR MEDICINE, cilt.36, sa.1, ss.33-42, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 1
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1007/s12149-021-01681-w
  • Dergi Adı: ANNALS OF NUCLEAR MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.33-42
  • Anahtar Kelimeler: Parathyroid adenoma, Diagnosis, Oxyphils, Scintigraphy, Sestamibi, Uniglandular parathyroid disease, OXYPHIL CELL CONTENT, PRIMARY HYPERPARATHYROIDISM, PREOPERATIVE LOCALIZATION, BIOLOGICAL FACTORS, SCINTIGRAPHY, SENSITIVITY, TECHNETIUM-99M-SESTAMIBI, SCAN, SURGERY
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Purpose Technetium-99 m sestamibi parathyroid scintigraphy (MIBI scan) has been used to localize abnormal glands in patients with primary hyperparathyroidism to guide parathyroidectomy. This series aimed to identify the biochemical and histopathological correlates of MIBI scan findings in patients with parathyroid adenoma. Methods A total of 378 patients with histologically and biochemically proven parathyroid adenoma were included. The results of MIBI scan, histopathological (gland volume and weight, oxyphil cell ratio), biochemical (blood and 24 h urine calcium, creatinine, glomerular filtration rate, parathormone, alkaline phosphate, and vitamin D3) variables were recorded. A positive uptake on the MIBI scan referred to a localized adenoma. Among histological variables, a cutoff of 30% was applied to define parathyroid adenomas with low (<= 30%) and high (> 30%) oxyphil cell content. Statistical analyses were performed to assess the relationship among variables. Results MIBI scan localized the adenoma in 306 patients. Parathyroid gland volume and weight, and oxyphil ratio were significantly higher in the MIBI scan-positive group. Among the biochemical variables, only PTH was found to be significantly increased in the MIBI scan-positive group. Binary logistic regression models identified statistically significant cutoffs for the gland volume (1700 mm(3)), gland weight (1.3 g) and PTH levels (170 pg/mL) that can be used to predict the MIBI scan positivity. Conclusion In addition to PTH levels, this series underscored the impact of cellular composition along with the parathyroid gland volume and weight, both of which correlate with sestamibi positivity in patients with benign uniglandular parathyroid disease.