The role of ultrasound and nuclear medicine methods in the preoperative diagnostics of primary hyperparathyroidism

• Authors: Michał Nieciecki , Marek Cacko , Leszek Królicki

Title variants

PL

Rola badania ultrasonograficznego i metod medycyny nuklearnej w przedoperacyjnej diagnostyce pierwotnej nadczynności przytarczyc

• Languages of publication: EN PL

Abstracts

EN

Primary hyperparathyroidism (PH) represents one of the most common endocrine diseases. In most cases, the disorder is caused by parathyroid adenomas. Bilateral neck exploration has been a widely used treatment method for adenomas since the 20’s of the twentieth century. In the last decade, however, it has been increasingly replaced by a minimally invasive surgical treatment. Smaller extent, shorter duration and lower complication rate of such a procedure are emphasized. Its efficacy depends on a precise location of parathyroid tissue during the preoperative imaging. Scintigraphy and ultrasound play a major role in the diagnostic algorithms. The efficacy of both methods has been repeatedly verified and compared. The still-current guidelines of the European Association of Nuclear Medicine (2009) emphasize the complementary role of scintigraphy and ultrasonography in the preoperative diagnostics in patients with primary hyperparathyroidism. At the same time, attempts are made to improve both these techniques by implementing new study protocols or innovative technologies. Publications have emerged in the recent years in the field of ultrasonography, whose authors pointed out the usefulness of elastography and contrast media. Nuclear medicine studies, on the other hand, focus mainly on the assessment of new radiotracers used in the positron emission tomography (PET). The aim of this article is to present, based on literature data, the possibilities of ultrasound and scintigraphy in the preoperative diagnostics in patients with primary hyperparathyroidism. Furthermore, the main directions in the development of imaging techniques in PH patients were evaluated.

PL

Pierwotna nadczynność przytarczyc jest jednym z najczęstszych schorzeń układu endokrynnego. Przyczyną większości przypadków tej choroby są gruczolaki przytarczyc. Od lat dwudziestych XX wieku powszechnie stosowaną metodą ich leczenia jest obustronna eksploracja szyi. W ostatniej dekadzie zastępowana jest ona jednak coraz częściej przez operacje wykonywane metodą mało inwazyjną. Podkreśla się mniejszą rozległość, krótszy czas trwania oraz niższy odsetek powikłań takiej procedury. Jej skuteczność uwarunkowana jest precyzyjną lokalizacją tkanki przytarczyc w przedoperacyjnych badaniach obrazowych. Główną rolę w algorytmach diagnostycznych odgrywają scyntygrafia i badanie ultrasonograficzne. Skuteczność obu metod była wielokrotnie weryfikowana oraz porównywana. Wciąż aktualne wytyczne Europejskiego Towarzystwa Medycyny Nuklearnej z 2009 roku podkreślają komplementarną rolę scyntygrafii i badania ultrasonograficznego w przedoperacyjnej diagnostyce pacjentów z pierwotną nadczynnością przytarczyc. Jednocześnie podejmowane są próby udoskonalenia obu metod, poprzez zastosowanie nowych protokołów badań lub wykorzystanie innowacyjnych technologii. W dziedzinie ultrasonografii w ostatnich latach pojawiły się publikacje, których autorzy zwracali uwagę na przydatność elastografii oraz środków kontrastowych. Natomiast prace z zakresu medycyny nuklearnej koncentrują się głównie na ocenie nowych radioznaczników stosowanych w pozytonowej tomografii emisyjnej. Celem tego artykułu jest przedstawienie, na podstawie danych z literatury, możliwości badania ultrasonograficznego i scyntygrafii w przedoperacyjnej diagnostyce pacjentów z pierwotną nadczynnością przytarczyc. Dodatkowo analizowano główne kierunki rozwoju metod obrazowania chorych z opisywanym schorzeniem.

Keywords

EN

PET; hyperparathyroidism; nadczynność przytarczyc; scintigraphy; scyntygrafi a; ultrasonografi a; ultrasonography

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Journal of Ultrasonography
• Year: 2015
• Volume: 15
• Issue: 63
• Pages: 398-409

Contributors

author

Michał Nieciecki

• Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland

author

Marek Cacko

• Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland

author

Leszek Królicki

• Department of Diagnostic Imaging, Mazovian Bródno Hospital, Warsaw, Poland. Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland

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• Document Type: review