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J D Hydovitz

Publications and source records attributed to J D Hydovitz.

13 recordsLinked to original sources
PubMed1985

Radionuclide imaging of parathyroid tumors: historical perspectives and newer techniques.

The increasing use of automated blood chemistry screens for serum calcium levels along with improved methods in measuring parathyroid hormone (PTH) levels have made the diagnosis of parathyroid disease a common clinical problem. Parathyroid adenomas account for the majority of primary hyperparathyroidism with diffuse hyperplasia and parathyroid carcinoma occurring less frequently. Early scintigraphic techniques to identify enlarged parathyroids used selenomethionine-75 which was considered to be incorporated into PTH. In general, the sensitivity of scanning the neck using this tracer was related to the size of the enlarged parathyroid, but in large series, the overall sensitivity was less than 50%. Recent work by Ferlin et al, using a Technetium-99m/Thallium-201 subtraction scintigraphic technique has yielded a sensitivity of 92% in identifying pathologically enlarged parathyroid glands. Winzelberg et al modified this technique to allow imaging the mediastinum plus simplifying the subtraction method. In a prospective study with high-resolution sonography, similar sensitivities and specificities were found with sonography and scintigraphy. Tl-201/Tc-99m pertechnetate subtraction scintigraphy appears to be an accurate technique in identifying pathologic parathyroid enlargement. Its ultimate role in the evaluation of patients with suspected hyperparathyroidism still needs to be determined.

Adenoma↗
PubMed1985

Parathyroid adenomas evaluated by Tl-201/Tc-99m pertechnetate subtraction scintigraphy and high-resolution ultrasonography.

Thallium-201/technetium-99m pertechnetate subtraction scintigraphy of the parathyroid glands was performed in a prospective study of 33 patients who had undergone bilateral neck exploration for elevated serum calcium and serum parathyroid hormone levels. In 31 cases, the Tl-201/Tc-99m subtraction technique yielded an overall sensitivity of 81%, specificity of 99%, and accuracy of 94% for identifying solitary parathyroid adenomas. Tl-201/Tc-99m subtraction scintigraphy correctly identified 73% of parathyroid adenomas weighing less than 499 mg, 79% of those weighing 500-1,499 mg, and 100% of adenomas weighing more than 1,500 mg. In a subgroup of 24 patients with solitary parathyroid adenomas who underwent both scintigraphy and high-resolution sonography, the sensitivity, specificity, and accuracy of both procedures were similar.

Adenoma↗
PubMed1984

Parathyroid adenomas studied by digital subtraction angiography.

Eighteen patients who had elevated serum calcium and parathormone levels were prospectively studied with intravenous digital subtraction angiography (DSA). Intravenous DSA of the neck and mediastinum was performed in the anteroposterior, the left anterior, and the right anterior oblique projections. The study was considered positive if an abnormal blush or blood supply was noted. Upon operation, 14 patients were confirmed to have parathyroid adenomas, of whom five had positive preoperative DSA examinations. Four patients were followed medically (three negative DSA, one positive DSA). A positive intravenous DSA may be useful to guide neck explorations for parathyroid adenomas; however, the low sensitivity of the study may limit its screening potential.

Adenoma↗