Pre-operative localization of abnormal parathyroid tissue by 99m Tc-sestamibi in primary hyperparathyroidism using four-
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Pre-operative localization of abnormal parathyroid tissue by 99m Tc-sestamibi in primary hyperparathyroidism using fourquadrant site analysis: an evaluation of the predictive value of vitamin D deficiency Yu-Kwang Donovan Tay John P. Bilezikian1
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Randy Yeh4 Jennifer H. Kuo5 Catherine McManus5 James A. Lee5 ●
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Received: 8 October 2017 / Accepted: 9 January 2018 / Published online: 5 February 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Context Accurate preoperative localization of abnormal parathyroid tissue aids importantly in minimally invasive parathyroidectomy in patients with primary hyperparathyroidism. Vitamin D deficiency may possibly influence the success and characteristics of pre-operative localization because it is associated with more active disease and possibly larger adenomas. This could increase the sensitivity of the sestamibi to identify abnormal parathyroid tissue, but earlier reports are conflicting. Vitamin D deficiency could also influence the nature of preoperative localization because it could lead to multi-gland stimulation of parathyroid tissue giving an appearance of multi-gland disease, which may lower accuracy of preoperative localization with sestamibi. Objective To examine the relationship between vitamin D deficiency and correct parathyroid tissue localization by four-pole thyroid quadrant analysis. Design Retrospective study. Setting Referral center. Participants A total of 138 patients were divided into three groups according to the level of 25OHD;
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