THE RELIABILITY OF TC-99M SESTAMIBI SCINTIGRAPHY BASED ON PATHOLOGICAL FINDINGS IN 210 PATIENTS WITH PARATHYROID ADENOMA: A RETROSPECTIVE OBSERVATIONAL STUDY chorange2404@gmail.com

PW06-01

THE RELIABILITY OF TC-99M SESTAMIBI SCINTIGRAPHY BASED ON PATHOLOGICAL FINDINGS IN 210 PATIENTS WITH PARATHYROID ADENOMA: A RETROSPECTIVE OBSERVATIONAL STUDY

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Theodossis Papavramidis papavramidis@hotmail.com AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki 1st Propedeutic Department of Surgery Thessaloniki Greece

Greece

Oral or Poster

Primary hyperparathyroidism (PHPT) is most often caused by a solitary parathyroid adenoma. Accurate preoperative localization is key for successful minimally invasive parathyroidectomy. Tc99m-sestamibi scintigraphy, especially when combined with SPECT/CT, is widely used for this purpose. However, the correlation between imaging and histopathological findings remains under investigation. This study assesses the concordance between preoperative Tc99m-sestamibi imaging and histological localization in patients undergoing parathyroidectomy.

A retrospective study was performed on 210 patients who underwent surgery for a single parathyroid adenoma. All patients had preoperative Tc99m-sestamibi scans. Imaging results were compared to postoperative histopathological localization. Statistical analysis included cross-tabulation and Pearson’s chi-square test. Additional variables such as age, serum calcium, parathyroid hormone (PTH) levels, and adenoma weight and size were also evaluated.

Tc99m-sestamibi most frequently identified adenomas in the lower parathyroid glands: 43.8% in the left lower and 35.2% in the right lower quadrant. Histology confirmed similar distributions. Concordance between imaging and histology was highest in the left lower (100%) and right upper glands (100%), followed by the right lower (91.9%) and left upper (87%). Pearson’s chi-square test demonstrated a significant association (χ² = 559.721, df = 16, p < 0.001). No significant correlation was found between localization accuracy and patient demographics or biochemical markers.

Tc99m-sestamibi scintigraphy shows excellent agreement with histopathological findings and remains a reliable preoperative localization method for parathyroid adenomas. These results support its continued use in guiding targeted surgical intervention in PHPT patients.