Dynamic Parathyroid Computed Tomography (4DCT) Facilitates Reoperative Parathyroidectomy and Enables Cure of Missed Hyperplasia

Background Four-dimensional computed tomography (4DCT) is an emerging imaging modality in the evaluation of primary hyperparathyroidism (PHPT). We assessed the role of 4DCT in patients presenting for reoperative parathyroidectomy. Methods A prospective database of patients with persistent or recurre...

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Bibliographic Details
Published in:Annals of surgical oncology 2015-10, Vol.22 (11), p.3537-3542
Main Authors: Cham, Stephanie, Sepahdari, Ali R., Hall, Kimberly E., Yeh, Michael W., Harari, Avital
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Endocrine Tumors
Female
Four-Dimensional Computed Tomography
Humans
Hyperparathyroidism, Primary - diagnostic imaging
Hyperparathyroidism, Primary - etiology
Hyperparathyroidism, Primary - surgery
Hyperplasia - complications
Hyperplasia - diagnostic imaging
Hyperplasia - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Operative Time
Parathyroid Glands - diagnostic imaging
Parathyroid Glands - pathology
Parathyroid Glands - surgery
Parathyroidectomy
Reoperation
Retrospective Studies
Surgery
Surgical Oncology
Treatment Outcome
Young Adult
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Summary:Background Four-dimensional computed tomography (4DCT) is an emerging imaging modality in the evaluation of primary hyperparathyroidism (PHPT). We assessed the role of 4DCT in patients presenting for reoperative parathyroidectomy. Methods A prospective database of patients with persistent or recurrent PHPT undergoing reoperative parathyroidectomy during the years 2006–2014 was analyzed. Patients treated before versus after the advent of 4DCT were compared for operative eligibility, operative success, operative time, and concordance of imaging results with surgical findings. Results Ninety patients were included in the study (61 before 4DCT, 29 after 4DCT). The post-4DCT group had a higher rate of surgical concordance with imaging results (63 vs. 90 %, p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-014-4331-0