Comparative characteristic of different methods for topical diagnostics of primary hyperparathyroidism

Abstract

Topical diagnostics of pathology of parathyroid glands (PTG) is an important stage of preoperative examination of the patients presenting with primary hyperparathyroidism (PHPT). Individual patients do not necessarily need the entire scope of the currently available diagnostic techniques to be applied for the elucidation of their clinical conditions. The objective of the present study was to estimate the diagnostic value of each concrete method and its combination with other tools. The data obtained point out to the high efficacy and specificity of each method of preoperative topical diagnostics of PTG pathology in the patients with PHPT. The sensitivity of ultrasound studies, scntiography, their combination, and multispiral computed tomography (MSCT) was estimated at 96.8%, 91.8%, 99.2%, and 95.2% respectively. Their specificity was 91.9%, 84.2%, 94.1%, and 94.1%. The study did not reveal a significant difference between sensitivity and specificity of ultrasound studies and the "golden standard" of diagnostics of PTG pathology. This finding allows the ultrasound studies to be recommended as the sole method for primary topical diagnostics of PTG pathology in the patients presenting with PHPT. At the same time, any doubt as regards the results of an ultrasound study requires that a more comprehensive examination of the patients be performed with use of the entire scope of the scintigraphic techniques including single-photon emission computed tomography (SPECT) and MSCT especially in the cases of atypical localization of parathyroid glands. The results of the study provided a basis for the development of the optimal algorithm for diagnostics of PHPT.