Incidentalomas during imaging for primary hyperparathyroidism—incidence and clinical outcomes

Background: Imaging for pre-operative localisation of parathyroid glands in primary hyperparathyroidism is now routine. This has led to the detection of incidental lesions (incidentalomas) in other organs, the nature of which is not well characterised. The aim of this study was to determine the incidence, characteristics and outcomes in patients who had incidental findings on parathyroid imaging. Methods: Records of patients who underwent imaging for primary hyperparathyroidism over 2 years were reviewed to identify incidental lesions detected on parathyroid imaging. Patients with persistent or renal hyperparathyroidism were excluded. Details on the management of detected incidentalomas were obtained from patient records. Results: Incidentalomas were identified in 17 of 170 patients (10 %) undergoing parathyroid imaging. Incidentalomas included thyroid (n = 11), breast (n = 3), lateral compartment of the neck (n = 1), lung (n = 1) and clavicle (n = 1). However, no disease of clinical significance needing treatment was detected on further investigation. Conclusions: Although a significant proportion of patients undergoing parathyroid imaging had incidental lesions detected, these seem to be of little clinical significance. The morbidity and cost of further interventions on these incidentalomas need to be weighed against the benefits of routine imaging in improving outcomes of first-time surgery in patients with primary hyperparathyroidism. Keywords: Parathyroid gland, Primary hyperparathyroidism, Imaging, Incidentaloma

Developing the Structure of a Cu CMP Model

Abstract: This paper discusses how we are using Cu CMP data to develop a Cu CMP model. CMP data were taken on a non-rotating wafer using a representative dual axis rotational polisher. The data are first analyzed using a mechanical model that incorporates Preston's law, rough surface contact mechanics, thin film fluid mechanics and basic load and moment balances. The limited success of this mechanical model, which was targeted at oxide CMP, motivated us to identify model elements that improve our understanding, including non-Prestonian behavior of the slurry and a thermally activated material removal process; i.e., chemically dominated. These model features were combined with simple mechanical model feature (load and moment balances), to successfully explain experimental observations