Abstract
Background: Four-dimensional computed tomography (4D-CT) is often used for patients with primary hyperparathyroidism and non-definitive localization after Sestamibi scan (MIBI) and ultrasound (US), but may expose patients to unnecessary radiation, typically between 10 and 26 millisieverts (mSv). We hypothesize that a simpler two-phase CT protocol would have a similar sensitivity, specificity and accuracy to those published for 4D-CT, while exposing the patient to less radiation. Methods: We reviewed 54 patients with primary hyperparathyroidism and non-definitive localization studies who had a two-phase CT between 2009 and 2012 at our tertiary referral center. Results: The mean radiation dose of two-phase CT over the course of the study was 5.2mSv (range 3.5mSv-9.1mSv). Two-phase CT had a 77% (CI=65%-86%) sensitivity and an 87% (CI=73%-95%) specificity to lateralize enlarged parathyroid glands to the correct side of the neck and a 58% (CI=45%-68%) sensitivity and 91% (CI=83%-94%) specificity to localize parathyroid tumors to the correct quadrant of the neck. The overall accuracy of two-phase CT to lateralize enlarged parathyroids was 81% (CI=73%, 88%) and the accuracy to localize enlarged parathyroids was 79% (CI=73%, 84%). Discussion: As a second line investigation two-phase CT has a similar sensitivity, specificity and accuracy to those published for 4D-CT in patients with non-localized, enlarged parathyroids with less radiation exposure. Two-phase CT can help localize enlarged parathyroid glands not definitively identified using MIBI and US. Conclusion: Two-phase CT allows clinicians to accurately identify enlarged parathyroid glands while exposing the patient to less radiation than 4D-CT.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 80-84 |
| Number of pages | 5 |
| Journal | International Journal of Surgery |
| Volume | 14 |
| DOIs | |
| State | Published - Feb 1 2015 |
Fingerprint
Keywords
- 4D-CT
- Hyperparathyroidism
- Two-phase ct
ASJC Scopus subject areas
- Surgery
Cite this
Two-phase (low-dose) computed tomography is as effective as 4D-CT for identifying enlarged parathyroid glands. / Campbell, Michael; Sicuro, Paul; Alseidi, Adnan; Blackmore, C. Craig; Ryan, John A.
In: International Journal of Surgery, Vol. 14, 01.02.2015, p. 80-84.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Two-phase (low-dose) computed tomography is as effective as 4D-CT for identifying enlarged parathyroid glands
AU - Campbell, Michael
AU - Sicuro, Paul
AU - Alseidi, Adnan
AU - Blackmore, C. Craig
AU - Ryan, John A.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background: Four-dimensional computed tomography (4D-CT) is often used for patients with primary hyperparathyroidism and non-definitive localization after Sestamibi scan (MIBI) and ultrasound (US), but may expose patients to unnecessary radiation, typically between 10 and 26 millisieverts (mSv). We hypothesize that a simpler two-phase CT protocol would have a similar sensitivity, specificity and accuracy to those published for 4D-CT, while exposing the patient to less radiation. Methods: We reviewed 54 patients with primary hyperparathyroidism and non-definitive localization studies who had a two-phase CT between 2009 and 2012 at our tertiary referral center. Results: The mean radiation dose of two-phase CT over the course of the study was 5.2mSv (range 3.5mSv-9.1mSv). Two-phase CT had a 77% (CI=65%-86%) sensitivity and an 87% (CI=73%-95%) specificity to lateralize enlarged parathyroid glands to the correct side of the neck and a 58% (CI=45%-68%) sensitivity and 91% (CI=83%-94%) specificity to localize parathyroid tumors to the correct quadrant of the neck. The overall accuracy of two-phase CT to lateralize enlarged parathyroids was 81% (CI=73%, 88%) and the accuracy to localize enlarged parathyroids was 79% (CI=73%, 84%). Discussion: As a second line investigation two-phase CT has a similar sensitivity, specificity and accuracy to those published for 4D-CT in patients with non-localized, enlarged parathyroids with less radiation exposure. Two-phase CT can help localize enlarged parathyroid glands not definitively identified using MIBI and US. Conclusion: Two-phase CT allows clinicians to accurately identify enlarged parathyroid glands while exposing the patient to less radiation than 4D-CT.
AB - Background: Four-dimensional computed tomography (4D-CT) is often used for patients with primary hyperparathyroidism and non-definitive localization after Sestamibi scan (MIBI) and ultrasound (US), but may expose patients to unnecessary radiation, typically between 10 and 26 millisieverts (mSv). We hypothesize that a simpler two-phase CT protocol would have a similar sensitivity, specificity and accuracy to those published for 4D-CT, while exposing the patient to less radiation. Methods: We reviewed 54 patients with primary hyperparathyroidism and non-definitive localization studies who had a two-phase CT between 2009 and 2012 at our tertiary referral center. Results: The mean radiation dose of two-phase CT over the course of the study was 5.2mSv (range 3.5mSv-9.1mSv). Two-phase CT had a 77% (CI=65%-86%) sensitivity and an 87% (CI=73%-95%) specificity to lateralize enlarged parathyroid glands to the correct side of the neck and a 58% (CI=45%-68%) sensitivity and 91% (CI=83%-94%) specificity to localize parathyroid tumors to the correct quadrant of the neck. The overall accuracy of two-phase CT to lateralize enlarged parathyroids was 81% (CI=73%, 88%) and the accuracy to localize enlarged parathyroids was 79% (CI=73%, 84%). Discussion: As a second line investigation two-phase CT has a similar sensitivity, specificity and accuracy to those published for 4D-CT in patients with non-localized, enlarged parathyroids with less radiation exposure. Two-phase CT can help localize enlarged parathyroid glands not definitively identified using MIBI and US. Conclusion: Two-phase CT allows clinicians to accurately identify enlarged parathyroid glands while exposing the patient to less radiation than 4D-CT.
KW - 4D-CT
KW - Hyperparathyroidism
KW - Two-phase ct
UR - http://www.scopus.com/inward/record.url?scp=84922775797&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922775797&partnerID=8YFLogxK
U2 - 10.1016/j.ijsu.2015.01.005
DO - 10.1016/j.ijsu.2015.01.005
M3 - Article
C2 - 25597235
AN - SCOPUS:84922775797
VL - 14
SP - 80
EP - 84
JO - International Journal of Surgery
JF - International Journal of Surgery
SN - 1743-9191
ER -