A new formula for predicting the actual volume of parathyroid adenoma in patients with primary hyperparathyroidism

Samenvatting

Backround/AimKnowing the adenoma volume in patients with primary hyperparathyroidism (PHPT) is useful for surgeons during parathyroidectomy. The primary aim of our study was to determine how to calculate adenoma volume with the greatest accuracy. Our secondary aim was to determine the relationship between adenoma volume and preoperative biochemical parameters (parathyroid hormone [PTH] and calcium levels).Material and MethodsWe prospectively collected the medical history of 75 patients who underwent surgery for a single parathyroid adenoma. After excision, the adenomas were placed in water-filled syringes and the actual volume was determined according to the amount of water displaced. The radiological volume of the adenomas was calculated using the ellipsoid body formula according to the ultrasonographic dimensions. The parathyroid hormone and calcium levels of the patients were obtained from their hospital records.ResultsThe calculated radiological volumes correlated with the actual adenoma volumes, but there were significant differences between the two measurements. A new formula was conducted based on actual volumes and radiological volumes. A positive correlation was found between the adenoma volumes and the preoperative PTH and calcium levels.ConclusionAdenoma volume calculated using a mathematical formula with ultrasound does not accurately reflect the actual volume. The higher a patient’s preoperative calcium and PTH levels, the larger that patient’s adenoma will be.