JAMA Otolaryngology’s Post

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In patients with primary hyperparathyroidism, first-line F18-choline PET/CT is a suitable and safe replacement for MIBI SPECT/CT, finds randomized clinical trial. https://ja.ma/4cljYgG

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Terrible surgery! Unbelievable persistence rates!. Why JAMA-Oto did publish such a paper? Just because it was, supposedly, a RCT. This is a sheer example of RCT mesmerizing editors, the dark side of evidence based medicine. 😪 😫 😱

Prof. Dr. Volker Fendrich

Medical Director, Head of Department of Endocrine Surgery, Ärztlicher Direktor und Chefarzt der Endokrinen Chirurgie und WSET Level 3 Absolvent und Assistant Sommelier

2mo

It will delay operations because of the very long waiting time for that procedure and especially for the health insurance companies to overtake the costs. It should be only recommended for persistent or recurrent pHPT.

Maurizio Iacobone

Associate Professor of Surgery - Head of the Endocrine Surgery Unit - University of Padua, Italy

2mo

Just 1 concern: the overall rate of success of surgery for pHPT is usually reported > 95%, even without preoperative localization studies. Here we have a rate of normocalcemia 85% after PetCholine and 56% after MIBI Scan! Just to be provocative: Should we argue that no localizing studies should be the first line strategy?

João Capela Costa, MD MSc FICS FEBS(ED)

Presidente na Sociedade Portuguesa de Cirurgia Endócrina

2mo

I think the problem is the skill of the surgical teams and not the method of glandular localization

Frank Weber

Professor of Surgery bei University Hospital Essen

2mo

important to set up such trial; but Normocalcemia at 1 month after positive first-line imaging-guided MIP was observed in 23 of 27 patients (85%) in the FCH1 group and 14 of 25 patients (56%) in the MIBI1 group. Sorry for beeing so blunt - but this is an unacceptable cure rate

Anders Bergenfelz

Professor emeritus, Chairman BJS Foundation Ltd,Doctor honoris causa, Jagiellonian University Krakow, Honorary member of the European Society of Endocrine Surgeons (ESES)

2mo

The results are frightening. Also, 57 patients in four centres over almost 3 years! How many patients were screened for participation? How many patients were operated at the centres during the study period?

Anders Bergenfelz

Professor emeritus, Chairman BJS Foundation Ltd,Doctor honoris causa, Jagiellonian University Krakow, Honorary member of the European Society of Endocrine Surgeons (ESES)

2mo

👍

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