[Three combined imaging studies' diagnostic value for preoperative position of hyperthyroidism]

Area of Science:

• Endocrinology
• Radiology
• Surgical Oncology

Background:

• Secondary hyperparathyroidism (SHPT) is a common complication in patients with chronic kidney disease.
• Accurate preoperative localization of parathyroid glands is crucial for successful surgical intervention.
• Current imaging modalities have limitations in precisely identifying all affected glands.

Purpose of the Study:

• To evaluate the diagnostic value of combining three imaging techniques for preoperative localization of secondary hyperparathyroidism.
• To compare the sensitivity and specificity of individual imaging methods versus a combined approach.

Main Methods:

• Retrospective analysis of 72 patients with SHPT who underwent parathyroid gland resection.
• Patients underwent preoperative color Doppler ultrasound, 99mTC-MIBI scintigraphy, and magnetic resonance imaging.
• Diagnostic performance metrics (sensitivity, specificity) were calculated and statistically analyzed against pathological findings.

Main Results:

• The combined three imaging studies achieved a sensitivity of 82.27%, significantly higher than individual methods.
• Individual imaging sensitivities were: MRI (72.70%), 99mTC-MIBI (47.52%), and ultrasound (44.33%).
• Specificities varied, with ultrasound (95.14%) and 99mTC-MIBI (91.75%) showing higher values than the combined approach (67.96%).

Conclusions:

• The combination of color Doppler ultrasound, 99mTC-MIBI scintigraphy, and MRI offers superior diagnostic value for preoperative localization in SHPT.
• This integrated imaging strategy enhances the identification of hyperplastic parathyroid glands, improving surgical planning and outcomes.
• Combined imaging represents an effective method to guide surgical treatment for secondary hyperparathyroidism.