A Study on Imaging Modalities in Primary Hyperparathyroidism
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 11
Abstract
Background: Hyperparathyroidism (HPT) is the third most common endocrine disease. The rate of incidence is increasing with the more extensive availability of early screening methods including levels of serum parathyroid hormone (PTH) and calcium. Primary HPT (PHPT) results from unregulated overproduction of the PTH, usually due to a parathyroid adenoma or hyperplasia. With the advent of minimally invasive parathyroid surgeries, the need to differentiate between the two has arisen in clinical practice. Materials and Methods: A total of 32 cases of PHPT were studied. Pre-operative localization was done using ultrasonography (8-12 MHz linear transducer probe), magnetic resonance imaging (1.5 Tesla), and technetium 99 m–methoxyisobutyl isonitrile (Tc99m Sesta MIBI) scan. Parathyroidectomy was performed, and histological analysis was done to confirm the clinical diagnosis. The expression of Ki-67 and p53 was analyzed in the tumor tissue in 22 patients. Results: It was found that double imaging modality had higher sensitivity and specificity for adenomas as compared to either individual scan. Immunohistochemical analysis showed increased uptake of Ki67 in adenomas and hyperplasia as compared to normal tissue. P53 uptake was seen on both adenomas and hyperplasia. Conclusion: Double imaging modality is better than using single imaging modality in the identification of HPT.
Authors and Affiliations
Saravanan Sanniyasi, Sankar Narayanan, Cunnigaiper Dhanasekaran Narayanan
Keywords
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