The following is a summary of “Sonographic Features of Atypical and Initially Missed Parathyroid Adenomas: Lessons Learned From a Single-Center Cohort,” published in the February 2024 issue of Endocrinology by Ilgan, et al.
Accurate identification of ultrasonographic (US) features of parathyroid adenomas (PAs) is vital as US is the primary imaging modality for initial evaluation. For a study, researchers sought to characterize atypical features of PAs on US and identify factors contributing to false negative examinations in a large cohort from a single center.
The US records of 457 PAs in 445 patients with primary hyperparathyroidism (PHPT) were analyzed from a prospectively maintained database. Atypical size, composition, shape, echogenicity, location, and vascular pattern were assessed. Patients with previous negative US examinations in referring centers were evaluated for potential reasons.
Among 445 patients with PHPT (359 females, 86 males), 231 PAs (51%) exhibited typical US features, while 226 (49%) showed at least one atypical feature. The most common atypical features included size (29%), echogenicity (19%), shape (8%), location (7%), and composition (7%). A total of 122 initially missed PAs were identified. Atypical size (22.1%) and atypical location (18.8%) were the main reasons for false negative examinations, followed by inexperience (16.3%).
Nearly half of PAs display atypical US features. Recognizing these features could enhance US accuracy and potentially reduce the need for more costly second-line imaging modalities.
Reference: academic.oup.com/jcem/article-abstract/109/2/439/7260102