Two-phase (low-dose) computed tomography is as effective as 4D-CT for identifying enlarged parathyroid glands

Michael Campbell, Paul Sicuro, Adnan Alseidi, C. Craig Blackmore, John A. Ryan

Research output: Contribution to journalArticle

12 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)80-84
Number of pages5
JournalInternational Journal of Surgery
Volume14
DOIs
StatePublished - Feb 1 2015

Fingerprint

Four-Dimensional Computed Tomography
Parathyroid Glands
Tomography
Radiation
Primary Hyperparathyroidism
Neck
Sensitivity and Specificity
Tertiary Care Centers

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 journalArticle

Campbell, Michael ; Sicuro, Paul ; Alseidi, Adnan ; Blackmore, C. Craig ; Ryan, John A. / Two-phase (low-dose) computed tomography is as effective as 4D-CT for identifying enlarged parathyroid glands. In: International Journal of Surgery. 2015 ; Vol. 14. pp. 80-84.
@article{a1daf6051e4b4c1b9a5b86f6dd9e4ceb,
title = "Two-phase (low-dose) computed tomography is as effective as 4D-CT for identifying enlarged parathyroid glands",
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.",
keywords = "4D-CT, Hyperparathyroidism, Two-phase ct",
author = "Michael Campbell and Paul Sicuro and Adnan Alseidi and Blackmore, {C. Craig} and Ryan, {John A.}",
year = "2015",
month = "2",
day = "1",
doi = "10.1016/j.ijsu.2015.01.005",
language = "English (US)",
volume = "14",
pages = "80--84",
journal = "International Journal of Surgery",
issn = "1743-9191",
publisher = "Elsevier BV",

}

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 -