Ramli, Shahrul Fariz (2021) Retrospective evaluation of pre-operative imaging and factors affecting localisation and surgical outcome in primary hyperparathyroidism. Masters thesis, Universiti Sains Malaysia.
![[img]](http://eprints.usm.my/style/images/fileicons/application_pdf.png) |
PDF
Download (565kB) |
Abstract
Introduction: Primary hyperparathyroidism is an endocrine disease that is most commonly caused by parathyroid adenoma. Focused surgery with the aid of the advancement of pre-operative localisation together with intro-operative adjuncts allows shorter operative time and improve surgical outcome. This study aims to evaluate the sensitivity of ultrasonography and Sestamibi scan for correct localisation of parathyroid adenoma. Methods: Data were retrospectively collected for patients that underwent parathyroidectomy for primary hyperparathyroidism between January 2014 to December 2018 in Hospital Putrajaya, a single high-volume endocrine centre. Patient included underwent both ultrasonography and Tc-Sestamibi scan. Demographics, pre-operative data, intra-operative gland location and surgical outcome were recorded. Data were analysed to assess the sensitivity and specificity of ultrasonography and Tc-Sestamibi scan for localising parathyroid adenoma as well as factors and that influences correct detection. Results: 86 patients fulfilled the inclusion and exclusion criteria. The sensitivity of ultrasound to detect adenoma was 65% with positive predictive value (PPV) and accuracy of 89.7% and 60.5% accuracy. Sestamibi scan had a sensitivity of 79.5% with PPV and accuracy of 88.6% and 72.1% respectively. Combining scan showed a sensitivity and PPV of 90.5% and 97.4% respectively with an accuracy of 88.4%. Adenoma weight and pre-operative PTH levels have no association of detectability by Sestamibi scan however on ultrasound, heavier adenomas and higher PTH levels influence detectability (p=0.021) Conclusion: Dual modality of pre-operative localisation increases the sensitivity of parathyroid adenoma detection. Heavier adenomas and higher pre-operative PTH levels influence detection by ultrasound however has no influence on detectability by Sestamibi scan.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Primary hyperparathyroidism, Ultrasonography |
| Subjects: | R Medicine R Medicine > RD Surgery |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | MUHAMMAD AKIF AIMAN AB SHUKOR |
| Date Deposited: | 14 Apr 2026 02:09 |
| Last Modified: | 03 Jun 2026 08:00 |
| URI: | http://eprints.usm.my/id/eprint/63876 |
Actions (login required)
 |
View Item |
