COMPARISON OF DIAGNOSTIC ACCURACY OF CONTRAST ENHANCED ULTRASOUND (CE-US) WITH SESTAMIBI/SPECT FOR LOCALISATION IN PRIMARY HYPERPARATHYROIDISM (PHPT) gpuri360@gmail.com

 

COMPARISON OF DIAGNOSTIC ACCURACY OF CONTRAST ENHANCED ULTRASOUND (CE-US) WITH SESTAMIBI/SPECT FOR LOCALISATION IN PRIMARY HYPERPARATHYROIDISM (PHPT)

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India

Oral only

The tryst with localisation of hyperparathyroidism has been a constant part of life of an endocrine surgeon. The reported sensitivity of CEUS to be between 66.7% to 98.4%, as compared to the pooled sensitivity of MIBI scan being 84–88%.

The study was a prospective observational study in which the patients with a biochemical diagnosis of primary hyperparathyroidism satisfying the inclusion criteria were taken and subjected to CE-US by a trained radiologist faculty member. The same faculty member performed the CE-US for all the patients. Then these patients got a MIBI scan done at the department of nuclear medicine. The findings of these scans were blinded from the respective faculty members. Final histopathological confirmation was the gold standard

The study recruited 104 patients with PHPT with a mean age of 44.3 years. The diagnostic accuracy of CEUS was 88.51%, 92.86%, and 80.65% for overall cases, single gland involvement, and multiglandular involvement respectively. The diagnostic accuracy of of MIBI in these scenarios was slightly lower at 82.76%, 87.5%, and 74.19%, respectively. The overall sensitivity of CEUS was comparable with MIBI at 90.9% and 87.01% respectively. Largest sample size for a prospectively conducted study.

The diagnostic accuracy, sensitivity, specificity, PPV and NPV of CEUS and MIBI were comparable and thus it is as effective a modality if not superior.