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01-04-2015 | Original Article

Management of thyroid nodules incidentally discovered on MIBI scanning for primary hyperparathyroidism

Authors: Tristan Greilsamer, Claire Blanchard, Niki Christou, Delphine Drui, Catherine Ansquer, Maelle Le Bras, Bertrand Cariou, Cécile Caillard, Emmanuelle Mourrain-Langlois, Anne Sophie Delemazure, Muriel Mathonnet, Françoise Kraeber-Bodéré, Eric Mirallié

Published in: Langenbeck's Archives of Surgery | Issue 3/2015

Abstract

Introduction

Parathyroid sestamibi scan is routinely performed before parathyroid surgery. A large number of thyroid cancers take up 99mTc-sestamibi (MIBI). Since 2001, thyroid nodules discovered on sestamibi, nodules >2 cm, and/or with suspicious criteria were resected. The aim of this study was to evaluate the results of this policy.

Methods

All patients operated on for hyperparathyroidism, with a MIBI and cervical ultrasonography (US) with a thyroid resection for nodule, were retrospectively included.

Results

From 2001 to 2013, 685 patients were operated on for hyperparathyroidism. Some 137 (85 % females) had both preoperative MIBI and cervical US and a thyroid resection. The mean age was 63.2 ± 12.8 years. Sixty-three patients had a total thyroidectomy and 74 a lobectomy. Thirty-six patients had a thyroid cancer. The median size of cancers was 6.5 mm (0.3–22 mm), and 23 (16.7 %) patients had microcarcinoma. Among the 137 patients, 44 (32 %) had a MIBI+ nodule including 22 cancers. Sixty-one percent of malignant nodules were MIBI+ (22/36). The median size of MIBI+ cancers was 15 mm (9–22 mm) versus 2 mm (0.3–17 mm) for MIBI− cancers (p = 0.03). Twenty-two percent of benign nodules were MIBI+ (22/101). Finally, the sensitivity, specificity, positive predictive value, and negative predictive value of MIBI were 61, 78, 50, and 85 %, respectively.

Conclusion

Thyroid nodules incidentally discovered on MIBI in hyperparathyroidism patients should be resected.

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Title: Management of thyroid nodules incidentally discovered on MIBI scanning for primary hyperparathyroidism
Authors: Tristan Greilsamer
Claire Blanchard
Niki Christou
Delphine Drui
Catherine Ansquer
Maelle Le Bras
Bertrand Cariou
Cécile Caillard
Emmanuelle Mourrain-Langlois
Anne Sophie Delemazure
Muriel Mathonnet
Françoise Kraeber-Bodéré
Eric Mirallié
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 3/2015
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-015-1286-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Management of thyroid nodules incidentally discovered on MIBI scanning for primary hyperparathyroidism

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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