Is bilateral jugular venous sampling a suitable strategy for primary hyperparathyroidism cases with parathyroid glands that cannot be localized with Sestamibi?

Hüseyin Alakuş; Mustafa Göksu; Mahmut Çoraplı

doi:10.7197/cmj.946660

Research Article

Year 2021, Volume: 43 Issue: 4, 404 - 412, 31.12.2021

Hüseyin Alakuş , Mustafa Göksu , Mahmut Çoraplı

https://doi.org/10.7197/cmj.946660

Abstract

References

1. Ribeiro DK, Lera MM, Fonseca ABR, das Neves MC. Analysis of PTH serum concentration from internal jugular veins of patients with primary hyperparathyroidism. Archives of Head and Neck Surgery. 2020;48(2):0-.
2. Bilezikian JP, Bandeira L, Khan A, Cusano NE. Hyperparathyroidism. The Lancet. 2018;391(10116):168-78.
3. Rao DS, Honasoge M, Divine GW, Phillips ER, Lee MW, Ansari MR, et al. Effect of vitamin D nutrition on parathyroid adenoma weight: pathogenetic and clinical implications. The Journal of Clinical Endocrinology & Metabolism. 2000;85(3):1054-8.
4. Campbell MJ. The definitive management of primary hyperparathyroidism: who needs an operation? Jama. 2017;317(11):1167-8.
5. Urkan M, Peker Y, Ozturk E. Minimally Invasıve parathyroidectomy for primary hyperparathyroidism. . Acta Endocrinologica (Bucharest). 2019;15(2):182.
6. Khokar AM, Kuchta KM, Moo-Young TA, Winchester DJ, Prinz RA. Increasing trend of bilateral neck exploration in primary hyperparathyroidism. The American Journal of Surgery. 2020;219(3):466-70.
7. Lee NC, Norton JA. Multiple-gland disease in primary hyperparathyroidism: a function of operative approach? Archives of Surgery. 2002;137(8):896-900.
8. Ibraheem K, Toraih EA, Haddad AB, Farag M, Randolph GW, Kandil E. Selective parathyroid venous sampling in primary hyperparathyroidism: A systematic review and meta‐analysis. The Laryngoscope. 2018;128(11):2662-7.
9. De Feo ML, Colagrande S, Biagini C, Tonarelli A, Bisi G, Vaggelli L, et al. Parathyroid glands: combination of 99mTc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology. 2000;214(2):393-402.
10. Bunch PM, Kelly HR. Preoperative imaging techniques in primary hyperparathyroidism: a review. JAMA Otolaryngology–Head & Neck Surgery. 2018;144(10):929-37.
11. de Maissin C, Leclère J-C, Roudaut N, Thuillier P, Monguillon P, Marianowski R, et al. Evaluation of the performance of ultrasonography and 99mTc-sestamibi scintigraphy for primary hyperparathyroidism surgery. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2020.
12. Yen TW, Wang TS, Doffek KM, Krzywda EA, Wilson SD. Reoperative parathyroidectomy: an algorithm for imaging and monitoring of intraoperative parathyroid hormone levels that results in a successful focused approach. Surgery. 2008;144(4):611-21.
13. Uludağ M. Preoperative Localization Studies in Primary Hyperparathyroidism. Şişli Etfal Hastanesi Tip Bülteni. 2019;53(1):7-15.
14. Jones JJ, Brunaud L, Dowd CF, Duh Q-Y, Morita E, Clark OH. Accuracy of selective venous sampling for intact parathyroid hormone in difficult patients with recurrent or persistent hyperparathyroidism. Surgery. 2002;132(6):944-51.
15. Barczynski M, Konturek A, Hubalewska-Dydejczyk A, Cichon S, Nowak W. Utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing in guiding patients with a negative sestamibi scan for minimally invasive parathyroidectomy—a randomized controlled trial. Langenbeck's archives of surgery. 2009;394(5):827-35.
16. Alvarado R, Meyer-Rochow G, Sywak M, Delbridge L, Sidhu S. Bilateral internal jugular venous sampling for parathyroid hormone determination in patients with nonlocalizing primary hyperparathyroidism. World journal of surgery. 2010;34(6):1299-303. 17. Miller D. Endocrine angiography and venous sampling. Radiologic Clinics of North America. 1993;31(5):1051-67.
18. Edwards CM, Folek J, Dayawansa S, Govednik CM, Quinn CE, Sigmond BR, et al. Central venous parathyroid hormone monitoring using a novel, specific anatomic method accurately predicts cure during minimally invasive parathyroidectomy. The American Journal of Surgery. 2016;212(6):1154-61.
19. Abdel-Misih SR, Broome JT, Li X, Arrese D, Jacobs JK, Chambers EP, et al. Changing intraoperative parathyroid hormone collection sites from peripheral to central does not affect predictive accuracy during minimally invasive parathyroidectomy. Annals of surgical oncology. 2011;18(3):771-6.
20. Broome JT, Schrager JJ, Bilheimer D, Chambers EP, Jacobs JK, Phay J. Central venous sampling for intraoperative parathyroid hormone monitoring: are peripheral guidelines applicable? The American surgeon. 2007;73(7):712-6.
21. Maceri DR, Kokot N, Green K, Montgomery V, Sharifi J. Split central venous sampling of parathyroid hormone: an adjunct to surgical exploration. Head & neck. 2011;33(12):1715-8.
22. Liddy S, Worsley D, Torreggiani W, Feeney J. Preoperative imaging in primary hyperparathyroidism: literature review and recommendations. Canadian Association of Radiologists Journal. 2017;68(1):47-55.
23. Gilat H, Cohen M, Feinmesser R, Benzion J, Shvero J, Segal K, et al. Minimally invasive procedure for resection of a parathyroid adenoma: the role of preoperative high‐resolution ultrasonography. Journal of Clinical Ultrasound. 2005;33(6):283-7.
24. Kobylecka M, Płazińska MT, Chudziński W, Fronczewska-Wieniawska K, Mączewska J, Bajera A, et al. Porównanie badania ultrasonograficznego i scyntygraficznego w lokalizacyjnej diagnostyce przedoperacyjnej przytarczyc u chorych z pierwotną, wtórną i trzeciorzędową nadczynnością–doświadczenia własne.
25. Kluijfhout WP, Vorselaars WM, Vriens MR, Rinkes IHB, Valk GD, de Keizer B. Enabling minimal invasive parathyroidectomy for patients with primary hyperparathyroidism using Tc-99m-sestamibi SPECT–CT, ultrasound and first results of 18F-fluorocholine PET–CT. European journal of radiology. 2015;84(9):1745-51.
26. Cheung K, Wang TS, Farrokhyar F, Roman SA, Sosa JA. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Annals of surgical oncology. 2012;19(2):577-83.
27. Gambaro G, Croppi E, Coe F, Lingeman J, Moe O, Worcester E, et al. Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement. Journal of nephrology. 2016;29(6):715-34.
28. Vitetta GM, Neri P, Chiecchio A, Carriero A, Cirillo S, Mussetto AB, et al. Role of ultrasonography in the management of patients with primary hyperparathyroidism: retrospective comparison with technetium-99m sestamibi scintigraphy. Journal of ultrasound. 2014;17(1):1-12.
29. Ruda JM, Hollenbeak CS, Stack Jr BC. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngology—Head and Neck Surgery. 2005;132(3):359-72.
30. Erbil Y, Barbaros U, Yanik BT, Salmaslioğlu A, Tunaci M, Adalet I, et al. Impact of gland morphology and concomitant thyroid nodules on preoperative localization of parathyroid adenomas. Laryngoscope. 2006;116:580-5.
31. Mariani G, Bruselli L, Kuwert T, Kim EE, Flotats A, Israel O, et al. A review on the clinical uses of SPECT/CT. European journal of nuclear medicine and molecular imaging. 2010;37(10):1959-85.
32. Geatti O, Shapiro B, Orsolon PG, Proto G, Guerra UP, Antonucci F, et al. Localization of parathyroid enlargement: experience with technetium-99m methoxyisobutylisonitrile and thallium-201 scintigraphy, ultrasonography and computed tomography. European journal of nuclear medicine. 1994;21(1):17-22.
33. Coakley A, Kettle A, Wells C, O'Doherty M, Collins R. 99Tcm sestamibi—a new agent for parathyroid imaging. Nuclear medicine communications. 1989;10(11):791-4.
34. Greenspan BS, Dillehay G, Intenzo C, Lavely WC, O'Doherty M, Palestro CJ, et al. SNM practice guideline for parathyroid scintigraphy 4.0. Journal of nuclear medicine technology. 2012;40(2):111-8.
35. Eslamy HK, Ziessman HA. Parathyroid scintigraphy in patients with primary hyperparathyroidism: 99mTc sestamibi SPECT and SPECT/CT. Radiographics. 2008;28(5):1461-76.
36. Solorzano CC, Carneiro-Pla D. Minimizing cost and maximizing success in the preoperative localization strategy for primary hyperparathyroidism. Surgical Clinics. 2014;94(3):587-605.
37. Ito F, Sippel R, Lederman J, Chen H. The utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing. Annals of surgery. 2007;245(6):959.

Is bilateral jugular venous sampling a suitable strategy for primary hyperparathyroidism cases with parathyroid glands that cannot be localized with Sestamibi?

Year 2021, Volume: 43 Issue: 4, 404 - 412, 31.12.2021

Hüseyin Alakuş , Mustafa Göksu , Mahmut Çoraplı

https://doi.org/10.7197/cmj.946660

Abstract

Objective: Primary hyperparathyroidism (PHPT) is a common disorder. The surgical excision of all hyperfunctional parathyroid tissues is required to ensure long-term eucalcemia in these patients' curative treatment. This study aimed to evaluate whether parathormone (PTH) measurement via bilateral jugular venous sampling (BJVS) is an appropriate strategy for parathyroid adenoma lateralization in PHPT cases where parathyroid glands cannot be localized by imaging.

Method: The study included 22 cases diagnosed with PHPT, which could not be localized by ultrasonography and technetium-99m sestamibi scintigraphy (99mTc-MIBI). The patients’ PTH levels were measured using BJVS, and unilateral neck exploration (UNE) was performed in those detected to have lateralization. Success rate, permanent or temporary recurrent laryngeal nerve (RLN) injury, and hypoparathyroidism were evaluated.

Results: Parathyroid adenoma was successfully excised in 21 of 22 patients, and the success rate of PTH determination with BJVS was observed to be 94.5%. RLN injury and persistent hypoparathyroidism were not observed in any patient. Transient hypoparathyroidism was present in 9% of the patients.

Conclusions: In PHPT cases where parathyroid glands cannot be localized on ultrasonography and 99mTc-MIBI, UNE can be safely performed after achieving PTH level lateralization with preoperative BJVS without the need for advanced imaging methods.

Keywords

Hyperparathyroidism, Primary, Parathyroid Glands, Parathyroidectomy, Parathyroid venous sampling, Preoperative localization

References

1. Ribeiro DK, Lera MM, Fonseca ABR, das Neves MC. Analysis of PTH serum concentration from internal jugular veins of patients with primary hyperparathyroidism. Archives of Head and Neck Surgery. 2020;48(2):0-.
2. Bilezikian JP, Bandeira L, Khan A, Cusano NE. Hyperparathyroidism. The Lancet. 2018;391(10116):168-78.
3. Rao DS, Honasoge M, Divine GW, Phillips ER, Lee MW, Ansari MR, et al. Effect of vitamin D nutrition on parathyroid adenoma weight: pathogenetic and clinical implications. The Journal of Clinical Endocrinology & Metabolism. 2000;85(3):1054-8.
4. Campbell MJ. The definitive management of primary hyperparathyroidism: who needs an operation? Jama. 2017;317(11):1167-8.
5. Urkan M, Peker Y, Ozturk E. Minimally Invasıve parathyroidectomy for primary hyperparathyroidism. . Acta Endocrinologica (Bucharest). 2019;15(2):182.
6. Khokar AM, Kuchta KM, Moo-Young TA, Winchester DJ, Prinz RA. Increasing trend of bilateral neck exploration in primary hyperparathyroidism. The American Journal of Surgery. 2020;219(3):466-70.
7. Lee NC, Norton JA. Multiple-gland disease in primary hyperparathyroidism: a function of operative approach? Archives of Surgery. 2002;137(8):896-900.
8. Ibraheem K, Toraih EA, Haddad AB, Farag M, Randolph GW, Kandil E. Selective parathyroid venous sampling in primary hyperparathyroidism: A systematic review and meta‐analysis. The Laryngoscope. 2018;128(11):2662-7.
9. De Feo ML, Colagrande S, Biagini C, Tonarelli A, Bisi G, Vaggelli L, et al. Parathyroid glands: combination of 99mTc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology. 2000;214(2):393-402.
10. Bunch PM, Kelly HR. Preoperative imaging techniques in primary hyperparathyroidism: a review. JAMA Otolaryngology–Head & Neck Surgery. 2018;144(10):929-37.
11. de Maissin C, Leclère J-C, Roudaut N, Thuillier P, Monguillon P, Marianowski R, et al. Evaluation of the performance of ultrasonography and 99mTc-sestamibi scintigraphy for primary hyperparathyroidism surgery. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2020.
12. Yen TW, Wang TS, Doffek KM, Krzywda EA, Wilson SD. Reoperative parathyroidectomy: an algorithm for imaging and monitoring of intraoperative parathyroid hormone levels that results in a successful focused approach. Surgery. 2008;144(4):611-21.
13. Uludağ M. Preoperative Localization Studies in Primary Hyperparathyroidism. Şişli Etfal Hastanesi Tip Bülteni. 2019;53(1):7-15.
14. Jones JJ, Brunaud L, Dowd CF, Duh Q-Y, Morita E, Clark OH. Accuracy of selective venous sampling for intact parathyroid hormone in difficult patients with recurrent or persistent hyperparathyroidism. Surgery. 2002;132(6):944-51.
15. Barczynski M, Konturek A, Hubalewska-Dydejczyk A, Cichon S, Nowak W. Utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing in guiding patients with a negative sestamibi scan for minimally invasive parathyroidectomy—a randomized controlled trial. Langenbeck's archives of surgery. 2009;394(5):827-35.
16. Alvarado R, Meyer-Rochow G, Sywak M, Delbridge L, Sidhu S. Bilateral internal jugular venous sampling for parathyroid hormone determination in patients with nonlocalizing primary hyperparathyroidism. World journal of surgery. 2010;34(6):1299-303. 17. Miller D. Endocrine angiography and venous sampling. Radiologic Clinics of North America. 1993;31(5):1051-67.
18. Edwards CM, Folek J, Dayawansa S, Govednik CM, Quinn CE, Sigmond BR, et al. Central venous parathyroid hormone monitoring using a novel, specific anatomic method accurately predicts cure during minimally invasive parathyroidectomy. The American Journal of Surgery. 2016;212(6):1154-61.
19. Abdel-Misih SR, Broome JT, Li X, Arrese D, Jacobs JK, Chambers EP, et al. Changing intraoperative parathyroid hormone collection sites from peripheral to central does not affect predictive accuracy during minimally invasive parathyroidectomy. Annals of surgical oncology. 2011;18(3):771-6.
20. Broome JT, Schrager JJ, Bilheimer D, Chambers EP, Jacobs JK, Phay J. Central venous sampling for intraoperative parathyroid hormone monitoring: are peripheral guidelines applicable? The American surgeon. 2007;73(7):712-6.
21. Maceri DR, Kokot N, Green K, Montgomery V, Sharifi J. Split central venous sampling of parathyroid hormone: an adjunct to surgical exploration. Head & neck. 2011;33(12):1715-8.
22. Liddy S, Worsley D, Torreggiani W, Feeney J. Preoperative imaging in primary hyperparathyroidism: literature review and recommendations. Canadian Association of Radiologists Journal. 2017;68(1):47-55.
23. Gilat H, Cohen M, Feinmesser R, Benzion J, Shvero J, Segal K, et al. Minimally invasive procedure for resection of a parathyroid adenoma: the role of preoperative high‐resolution ultrasonography. Journal of Clinical Ultrasound. 2005;33(6):283-7.
24. Kobylecka M, Płazińska MT, Chudziński W, Fronczewska-Wieniawska K, Mączewska J, Bajera A, et al. Porównanie badania ultrasonograficznego i scyntygraficznego w lokalizacyjnej diagnostyce przedoperacyjnej przytarczyc u chorych z pierwotną, wtórną i trzeciorzędową nadczynnością–doświadczenia własne.
25. Kluijfhout WP, Vorselaars WM, Vriens MR, Rinkes IHB, Valk GD, de Keizer B. Enabling minimal invasive parathyroidectomy for patients with primary hyperparathyroidism using Tc-99m-sestamibi SPECT–CT, ultrasound and first results of 18F-fluorocholine PET–CT. European journal of radiology. 2015;84(9):1745-51.
26. Cheung K, Wang TS, Farrokhyar F, Roman SA, Sosa JA. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Annals of surgical oncology. 2012;19(2):577-83.
27. Gambaro G, Croppi E, Coe F, Lingeman J, Moe O, Worcester E, et al. Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement. Journal of nephrology. 2016;29(6):715-34.
28. Vitetta GM, Neri P, Chiecchio A, Carriero A, Cirillo S, Mussetto AB, et al. Role of ultrasonography in the management of patients with primary hyperparathyroidism: retrospective comparison with technetium-99m sestamibi scintigraphy. Journal of ultrasound. 2014;17(1):1-12.
29. Ruda JM, Hollenbeak CS, Stack Jr BC. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngology—Head and Neck Surgery. 2005;132(3):359-72.
30. Erbil Y, Barbaros U, Yanik BT, Salmaslioğlu A, Tunaci M, Adalet I, et al. Impact of gland morphology and concomitant thyroid nodules on preoperative localization of parathyroid adenomas. Laryngoscope. 2006;116:580-5.
31. Mariani G, Bruselli L, Kuwert T, Kim EE, Flotats A, Israel O, et al. A review on the clinical uses of SPECT/CT. European journal of nuclear medicine and molecular imaging. 2010;37(10):1959-85.
32. Geatti O, Shapiro B, Orsolon PG, Proto G, Guerra UP, Antonucci F, et al. Localization of parathyroid enlargement: experience with technetium-99m methoxyisobutylisonitrile and thallium-201 scintigraphy, ultrasonography and computed tomography. European journal of nuclear medicine. 1994;21(1):17-22.
33. Coakley A, Kettle A, Wells C, O'Doherty M, Collins R. 99Tcm sestamibi—a new agent for parathyroid imaging. Nuclear medicine communications. 1989;10(11):791-4.
34. Greenspan BS, Dillehay G, Intenzo C, Lavely WC, O'Doherty M, Palestro CJ, et al. SNM practice guideline for parathyroid scintigraphy 4.0. Journal of nuclear medicine technology. 2012;40(2):111-8.
35. Eslamy HK, Ziessman HA. Parathyroid scintigraphy in patients with primary hyperparathyroidism: 99mTc sestamibi SPECT and SPECT/CT. Radiographics. 2008;28(5):1461-76.
36. Solorzano CC, Carneiro-Pla D. Minimizing cost and maximizing success in the preoperative localization strategy for primary hyperparathyroidism. Surgical Clinics. 2014;94(3):587-605.
37. Ito F, Sippel R, Lederman J, Chen H. The utility of intraoperative bilateral internal jugular venous sampling with rapid parathyroid hormone testing. Annals of surgery. 2007;245(6):959.

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Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Surgical Science Research Articles
Authors	Hüseyin Alakuş 0000-0003-2650-7208 Mustafa Göksu 0000-0002-1807-6957 Mahmut Çoraplı 0000-0002-4223-7845
Publication Date	December 31, 2021
Acceptance Date	November 8, 2021
Published in Issue	Year 2021Volume: 43 Issue: 4

Cite

AMA	Alakuş H, Göksu M, Çoraplı M. Is bilateral jugular venous sampling a suitable strategy for primary hyperparathyroidism cases with parathyroid glands that cannot be localized with Sestamibi?. CMJ. December 2021;43(4):404-412. doi:10.7197/cmj.946660

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