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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenoma, Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Hyperparathyroidism, Hyperplasia, Male, Middle Aged, Parathyroid Glands, Parathyroid Neoplasms, Radionuclide Imaging, Ultrasonography.
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Do preoperative ultrasound and nuclear medicine studies improve the accuracy in localization of adenoma in hyperparathyroidism? Context: Today, minimizing the operating time makes preoperative hyperparathyroid lesion localization more valuable and it is routinely performed through ultrasound (US) and/or nuclear imaging (NI). We evaluated the accuracy of US and NI, used separately or concurrently, in the preoperative identification and localization of hyperparathyroid lesions. Retrospectively, patients receiving a parathyroidectomy for primary hyperparathyroidism from January 1985 through August 2000 were reviewed. The demographics, operative characteristics, serum laboratories, pathology, and radiology results were evaluated. A total of 226 operations were performed including 160 adenomas, 64 hyperplasia, and 2 carcinomas. For US the sensitivity was 67%, specificity 33%, and positive predictive value (PPV) 82%. For NI these values were 67%, 55%, and 86%, respectively. When either US or NI were positive, the results were 82%, 29%, and 85%, respectively. When both were positive, the results were 53%, 71%, and 90%, respectively. When both were positive, and had side concordance, the results were 53%, 100%, and 100%, respectively.
assistant
Positive NI correlated with an accurate pathologic location. Concordance of imaging tests increased specificity, PPV, and likelihood ratio. Negative localization on both imaging tests had a higher probability of being hyperplasia. Agreement of tests, especially when the side agrees, had a higher probability of adenoma. Final Decision: yes