Parathyroid adenoma localization: Surgeon-performed ultrasound versus sestamibi

Objectives: Compare surgeon-performed ultrasound versus sestamibi for preoperative parathyroid adenoma localization. Study Design. Single-institutional cohort. Methods: One hundred six consecutive patients undergoing parathyroidectomy at an academic institution between 2004 to 2005 were included. Of those, 103 underwent both surgeon-performed ultrasound and sestamibi-Tc99m localization preoperatively. Primary outcome is sensitivity for adenoma localization to correct quadrant (right vs. left, superior vs. inferior). Results: Hypercalcemia resolved in 97% of patients. Sensitivities for correct quadrant localization for ultrasound versus sestamibi were 87% versus 58% (P < .001). Specificities were 95%. Positive and negative predictive values were 85% versus 78% and 96% versus 87%, respectively. Combined sensitivity was 93%. Sensitivities for correct side localization were 91% and 74% (P = .002). Conclusions: Ultrasound appears more sensitive than sestamibi for localization to correct quadrant or side when performed in-office by the author in this cohort.