Use of dual energy computed tomography versus conventional techniques for preoperative localization in primary hyperparathyroidism: Effect of preoperative calcium and parathyroid hormone levels - 02/05/23
Abstract |
Background |
We aimed to investigate the association of preoperative calcium and parathyroid hormone (PTH) levels with sensitivity and accuracy of dual energy computed tomography (DECT), single-photon emission CT with 99mTc-sestamibi (CT-MIBI), and ultrasound (US) for pre-operative localization primary hyperparathyroid (PHP) patients.
Methods |
Patients undergoing parathyroidectomy for PHP at a tertiary care facility who underwent DECT, CT-MIBI and US between 2012 and 2021 were stratified by preoperative calcium and PTH levels.
Results |
Of 278 patients, those with high calcium and PTH levels had a higher sensitivity and accuracy with DECT (87.7%, 85.2%) compared to CT-MIBI (82.3%, 79.0%), and US (61.7%, 53.1%). DECT was more sensitive and accurate than other preoperative localization techniques in subgroups with normal PTH (DECT sensitivity 60.9%, accuracy 52.1%) and normal calcium levels (41.7%, 33.3%).
Conclusion |
Preoperative calcium and PTH were associated with sensitivity and accuracy of pre-operative localization in PHP. DECT was sensitive and accurate for preoperative localization compared to other first-line imaging techniques.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Sensitivity and accuracy of pre-operative localization of parathyroid glands is associated with Ca and PTH levels. |
• | DECT had a higher sensitivity and accuracy than CT MIBI and US in all patient subgroups. |
• | DECT had a salvage detection rate of 52.3% in patients for whom CT MIBI and US did not localize. |
• | DECT can be utilized as a first-line or salvage test when CT-MIBI and US are non-localizing. |
Keywords : Primary hyperparathyroidism, Parathyroidectomy, Dual energy computed tomography, Sestamibi, Pre-operative planning, Image localization, Calcium, Parathyroid hormone
Plan
Vol 225 - N° 5
P. 852-856 - mai 2023 Retour au numéro
Article précédent
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