• Rabiye Uslu Erdemir, İlhan Taşdöven, Taner Bayraktaroğlu, and Güldeniz Karadeniz Çakmak.
• Department of Nuclear Medicine, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
• Turk J Med Sci. 2021 Oct 21; 51 (5): 234123452341-2345.

Background/AimThis study aimed to evaluate the effect of sono-scintigraphic correlation on the success of minimal invasive parathyroidectomy (MIP) via surgeon performed continuous intraoperative sonographic guidance in patients operated for primary hyperparathyroidism (PHPT) without intact parathormone (PTH) measurement.Materials And MethodsA retrospective analysis of a prospective database was conducted to review patients who underwent MIP (July 2017-October 2019). The screened parameters were preoperative PTH level, preoperative ultrasonography (US), preoperative scintigraphy, intraoperative US, intraoperative frozen section analysis, postoperative PTH level, and permanent pathology rep ort. Intraoperative intact PTH measurement was not employed due to institutional policy.ResultsPreoperative US alone localized the specific side (right/left, inferior/superior) of abnormality in 54 out of 74 (72.97%) cases. Scintigraphy alone localized the specific side in 58 (78.37%) cases. The sensitivity of preoperative US and scintigraphy alone was 76.05% and 86.56%, respectively. Sono-scintigraphic discordance was present in 6 cases (8.1%) and intraoperative real-time US predicted accurate localization of adenoma in 4 (66.6%) and scintigraphy in 2 (44.4%) patients. The frozen section analysis confirmed parathyroid cells in all cases evaluated.ConclusionSono-scintigraphic concordance with intraoperative real-time imaging increases surgical success rates in cases where MIP is planned under the circumstances of limited resources regarding unavailability of intact PTH measurement.This work is licensed under a Creative Commons Attribution 4.0 International License.

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