Parathyroid 4D CT and Scintigraphy

Galvin, Leanne; Oldan, Jorge; Bahl, Manisha; Eastwood, James D.; Sosa, Julie Ann; Hoang, Jenny K.

doi:10.1177/0194599816630711

Cited by 46 publications

(35 citation statements)

References 16 publications

(47 reference statements)

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“…Significantly, the use of 4D CT greatly enhanced preoperative localization. 4D CT has higher sensitivity than scintigraphy for single and MGD [10]. Factors that may limit the sensitivity of 4D CT include MGD, multinodular goiter, and noisy images in patient with large body habitus [10].…”

Section: Resultsmentioning

confidence: 99%

“…While several studies documented higher sensitivity of 4D CT versus ultrasound and scintigraphy for detection of solitary parathyroid adenomas, 4D CT appears to be of particular high importance in patients with MGD [4], [10]. MGD represents real challenge for both radiologists and surgeons given the higher incidence of nonlocalizing imaging studies and failed surgeries in this population [10], [11].…”

Section: Discussionmentioning

confidence: 98%

“…This allows for accurate preoperative localization of even small adenomas. In their study, Galvin et al [10] highlighted the fact that the smallest lesion detected by scintigraphy was 10 mm versus 4 mm on 4D CT. In addition, the pattern of contrast enhancement of parathyroid adenoma is very characteristic, showing intense enhancement in the arterial phase (peak enhancement between 25 and 60 seconds following contrast injection) with washout of contrast in the delayed phases [1].…”

Section: Discussionmentioning

confidence: 99%

“…MGD represents real challenge for both radiologists and surgeons given the higher incidence of nonlocalizing imaging studies and failed surgeries in this population [10], [11]. Rodgers et al [4] found that 4D CT was more accurate than scintigraphy in patients with MGD, with sensitivities of 45% and 9%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Rodgers et al [4] found that 4D CT was more accurate than scintigraphy in patients with MGD, with sensitivities of 45% and 9%, respectively. Reasons behind the lower sensitivity of scintigraphy in MGD included its poor spacial resolution, specially for the smaller size adenomas commonly seen in MGD, in addition to the masking effect of retained radiopharmaceutical in the adjacent thyroid or submandibular glands [10].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Ectopic mediastinal parathyroid adenoma localized with four-dimensional CT: a case report

Elhelf

Kademian

Moritani

et al. 2017

Radiology Case Reports

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Ectopic mediastinal parathyroid adenoma localized with four-dimensional CT: a case report

Elhelf

Kademian

Moritani

et al. 2017

Radiology Case Reports

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Usefulness of¹⁸F-Fluorocholine Positron Emission Tomography–Computed Tomography in Locating Lesions in Hyperparathyroidism

Boccalatte

Higuera

Gómez

et al. 2019

JAMA Otolaryngol Head Neck Surg

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Identifying parathyroid glands correctly before a surgical procedure is essential to perform minimally invasive surgery. First-line tests with discordant or negative results underscore the need for more accurate imaging tests, thus decreasing the requirement for bilateral neck exploration or reintervention.OBJECTIVE To review the available evidence to determine positive predictive value, negative predictive value, sensitivity, and specificity in clinical cases in which 18 F-fluorocholine positron emission tomography-computed tomography (PET/CT) could be useful as a method to locate the lesions, and the benefits and controversial aspects of the method.EVIDENCE REVIEW A search was conducted using the PubMed Central and Cochrane Library databases for studies published in English from July 26, 2014, to November 30, 2018, using the search terms 18 choline, 18F choline, 18F-choline, 18 fluorocholine PET CT, hyperparathyroidism, primary hyperparathyroidism, secondary hyperparathyroidism, tertiary hyperparathyroidism, persistent hyperparathyroidism, recurrent hyperparathyroidism, ectopic hyperparathyroidism, and parathyroid adenoma. Other inclusion criteria were reporting at least 1 of the following measurements: negative or positive predictive value, sensitivity, and specificity of 18 F-fluorocholine PET/CT in the diagnosis of hyperparathyroidism (HPT). Exclusion criteria were language other than English, use of a tracer other than 18 F-fluorocholine, reports of a single case, and studies not related to HPT. The Oxford Centre classifications for levels of evidence were used.FINDINGS Sixteen studies fulfilled the inclusion criteria, comprising a total of 619 patients. Selected studies included 10 prospective cohort studies, 5 retrospective cohort studies, and 1 case series. Of the subtypes of HPT diagnosed using 18 F-fluorocholine PET/CT, 579 were primary HPT, 22 were secondary HPT, 1 was tertiary HPT, and 7 were associated with multiple endocrine neoplasia type I. Pathologically, the neoplasms comprised 459 adenomas, 59 hyperplasia, and 19 double adenomas.CONCLUSIONS AND RELEVANCE 18 F-fluorcholine PET/CT may be indicated when results of first-line tests are negative or discordant and in challenging clinical situations where locating the source of HPT is difficult.

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Direct Comparison of Preoperative Imaging Modalities for Localization of Primary Hyperparathyroidism

Lee

Shim

Jeong

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Accurate preoperative localization of primary hyperparathyroidism (pHPT) is an important and challenging issue for a successful parathyroidectomy. Although new imaging modalities have been introduced during the past decade, direct comparative studies on advanced imaging techniques are limited.OBJECTIVE To compare the performance of different preoperative imaging modalities for the localization of pHPT by performing a network meta-analysis (NMA).

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Parathyroid 4D CT and Scintigraphy

Abstract: 4D CT has higher sensitivity than scintigraphy. Missed lesions are more likely to occur with multigland disease for both modalities and in smaller lesions for scintigraphy.

Cited by 46 publications

References 16 publications

Ectopic mediastinal parathyroid adenoma localized with four-dimensional CT: a case report

Ectopic mediastinal parathyroid adenoma localized with four-dimensional CT: a case report

Usefulness of¹⁸F-Fluorocholine Positron Emission Tomography–Computed Tomography in Locating Lesions in Hyperparathyroidism

Direct Comparison of Preoperative Imaging Modalities for Localization of Primary Hyperparathyroidism

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Parathyroid 4D CT and Scintigraphy

Abstract: 4D CT has higher sensitivity than scintigraphy. Missed lesions are more likely to occur with multigland disease for both modalities and in smaller lesions for scintigraphy.

Cited by 46 publications

References 16 publications

Ectopic mediastinal parathyroid adenoma localized with four-dimensional CT: a case report

Ectopic mediastinal parathyroid adenoma localized with four-dimensional CT: a case report

Usefulness of18F-Fluorocholine Positron Emission Tomography–Computed Tomography in Locating Lesions in Hyperparathyroidism

Direct Comparison of Preoperative Imaging Modalities for Localization of Primary Hyperparathyroidism

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Usefulness of¹⁸F-Fluorocholine Positron Emission Tomography–Computed Tomography in Locating Lesions in Hyperparathyroidism