EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award WFUMB 2011 VIENNA AUSTRIA 28 August 2011 13.50 – 15.45 10 minutes each for presentation plus 3 minutes discussion
Ultrasound features of malignancy in the preoperative diagnosis of parathyroid cancer: a retrospective analysis of parathyroid tumours larger than 15mm Patel Preena, Talat Nadia (nadia.talat@nhs.net), Schulte KM, (klausmartin.schulte@nhs.net), Mulholland NJ, (nicolamulholland@nhs.net) Sidhu PS (paulsidhu@nhs.net)
ABSTRACT: Objective Nearly all reported parathyroid cancers are >15mm at presentation. The objective was to identify ultrasound criteria of malignancy in parathyroid lesions of >15mm in size. Materials and Methods This study was approved by a local ethics committee. A retrospective review of patients identified from a database from 2004-2009 was performed. All patients underwent ultrasound imaging according to the protocol. Two trained observers categorized findings using the predetermined features: shape, calcification, pattern of vascularity, local infiltration and internal lesion gray scale appearances. Results 69 patients (mean age 54.3 years, range 19-79 years; male=16, female=53) fulfilled the criteria of a parathyroid lesion >15mm; 8/69 (11.6%) with parathyroid cancer and 61/69 (88.4%) with benign solitary parathyroid adenoma. A high positive predictive value (PPV) for cancer was identified for infiltration (PPV 100%) and calcification (PPV 100%), whilst a high negative predictive value (NPV) was found for the absence of suspicious vascularity (NPV 97.6%), a thick capsule (NPV 96.7) and inhomogeneity (NPV 100%). Conclusion In lesions >15mm systematic ultrasound assessment of specific features provides a valuable tool to identify parathyroid cancers before surgery.