Four-dimensional computed tomography (4D-CT) for preoperative parathyroid localization: A good study but are we using it?

Autor: T.K. Pandian, Carrie C. Lubitz, Sareh Parangi, Lindsay E. Kuo, Sarah H. Bird, Antonia E. Stephen
Rok vydání: 2022
Předmět:
Zdroj: The American Journal of Surgery. 223:694-698
ISSN: 0002-9610
DOI: 10.1016/j.amjsurg.2021.09.015
Popis: Background Four-dimensional computed tomography (4D-CT) scan to localize abnormal parathyroid glands is diagnostically superior to ultrasound (US) and sestamibi. The implementation of 4D-CT imaging is unknown. Methods The Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) database from 2014 to 2018 was utilized. Patients with hyperparathyroidism undergoing an initial operation were included. The rate of US, sestamibi and 4D-CT performance was calculated for the entire study population, and for each institution. Results 7,959 patients were included. In 311(3.9%) patients, no preoperative imaging was recorded. Of patients with imaging, US was performed in 6,872(86.3%), sestamibi in 5,094(64.0%), and 4D-CT in 1,630(20.4%). The combination of US and sestamibi was most frequent (3,855, 48.4%). Institutional rates of 4D-CT performance varied from 0.1% to 88.7%. Conclusions Of the imaging modalities, 4D-CT was utilized least frequently and with greatest variability. Given the high accuracy of 4D-CT, efforts to reduce this variation may improve overall preoperative localization in patients with hyperparathyroidism.
Databáze: OpenAIRE
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