Primary Hyperparathyroidism: Comparing Between Solid and Cystic Adenomas and the Efficacy of Ultrasound and Single-Photon Emission Computed Tomography in their Diagnosis |
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| Institution: | 1. From the Massachusetts General Hospital, Harvard Medical School, Division of Interventional Radiology, Boston, Massachusetts;2. University of Massachusetts, Boston, College of Science and Mathematics, Boston, Massachusetts;3. Department of Nephrology, Imam Khomaini Hospital, Urmia University of Medical Sciences, Urmia, West Azarbaijan, Iran.;4. Solid Tumor Research Center, Imam Khomaini Hospital, Urmia University of Medical Sciences, Urmia, West Azarbaijan, Iran.;1. Department of Radiology, College of Medicine, Seoul St. Mary''s Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul 137-701, Republic of Korea;2. Department of General Surgery, College of Medicine, Seoul St. Mary''s Hospital, The Catholic University of Korea, Seoul, Republic of Korea;1. From the Geriatric Rehabilitation Department, University Hospital of Parma, Parma, Italy;2. Department of Clinical and Experimental Medicine, Section of Geriatrics, Food Sciences Unit and Endocrinology of Aging Unit, University of Parma, Parma, Italy;3. Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milano, Italy;4. Azienda Sanitaria Firenze, Firenze, Italy;5. Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy;6. National Institute on Aging, National Institutes of Health, Baltimore, Maryland.;1. From the Asun Medical Center, Seoul, Korea;2. Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea;3. Department of Radiology, Ajou University School of Medicine, Suwon, Korea;4. Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea;5. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea;6. Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.;1. From the Endocrinology Division, Department of Medicine, National University Hospital, Singapore;2. Yong Loo Lin School of Medicine, National University of Singapore;3. Department of Medicine, Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York;4. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore;5. The Endocrine Clinic, Mount Elizabeth Medical Centre, Singapore. |
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| Abstract: | Objective: Primary hyperparathyroidism (PHPT) is a disorder that results from abnormal functioning of the parathyroid glands. The purpose of this study was to compare cystic and solid adenomas by analyzing different variables associated with PHPT and parathyroid adenomas (age, calcium, phosphorus, and parathyroid hormone [PTH] levels, adenoma volume) while comparing the efficacy of ultrasound and single-photon emission computed tomography in differentiating between both types of adenoma.Methods: From 152 patients diagnosed with PHPT between January 2013 and 2014, only 109 patients who had positive ultrasonographic findings for single parathyroid adenoma were included in the study.Results: A total of 26 patients had cystic adenomas and 83 patients had solid adenomas. Sestamibi (MIBI) was negative in 50% of the cystic adenoma group and 27.7% of the solid adenoma group, with an overall technetium-MIBI efficacy of 67%. Age, phosphorus level, and adenoma volume were significantly higher in patients with cystic adenomas (P = .001, P = .02, and P = .02, respectively), whereas calcium and PTH levels were significantly higher in patients with solid adenomas (P = .02, P = .038, respectively). MIBI had a significant correlation with PTH levels (P = .031) and adenoma volume (P = .05) only in patients with solid adenomas. No significant correlation was found between sex and type of parathyroid adenoma.Conclusion: The current study is the first to compare age, PTH levels, and adenoma volume between cystic and solid adenoma patients, providing more information for the poorly understood pathology of cystic adenomas. Our findings showed that age and calcium and PTH levels are significantly higher in patients with solid adenomas, whereas adenoma volume and phosphorus levels are significantly higher in patients with cystic adenomas.Abbreviations: BMD = bone mineral density GFR = glomerular filtration rate iPTH = intact parathyroid hormone MIBI = sestamibi PHPT = primary hyperparathyroidism PTH = parathyroid hormone SPECT = single-photon emission computed tomography Tc = technetium US = ultrasound |
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