Role of Single-Photon Emission Computerised Tomography Versus Ultrasonography or 4D-Computed Tomography in the Management of Primary Hyperparathyroidism

IntroductionThe aim of the current study was to determine the diagnostic accuracy of three commonly used localization modalities for parathyroid adenomas, i.e., single-photon emission computerised tomography/computed tomography (SPECT/CT), ultrasound (USG) and 4D-computed tomography (4D-CT), especia...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-09, Vol.14 (9), p.e29015-e29015
Main Author: Pereira, Chirag
Format: Article
Language:English
Subjects:
Accuracy
Endocrine system
Endocrinology/Diabetes/Metabolism
General Surgery
Histology
Hyperplasia
Localization
Medical records
Nuclear Medicine
Radioisotopes
Scintigraphy
Surgeons
Thyroid gland
Tomography
Tumors
Ultrasonic imaging
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Summary:IntroductionThe aim of the current study was to determine the diagnostic accuracy of three commonly used localization modalities for parathyroid adenomas, i.e., single-photon emission computerised tomography/computed tomography (SPECT/CT), ultrasound (USG) and 4D-computed tomography (4D-CT), especially when used in combination.MethodsMedical records of patients diagnosed with primary hyperparathyroidism were reviewed from January 2015 to December 2020. Intra-operative findings were compared with preoperative localization studies (USG, SPECT/CT and 4D-CT) in order to determine sensitivity, specificity and accuracy of these studies.ResultsOne hundred eighty-nine medical records were reviewed. SPECT/CT has a sensitivity of 60.51% and a diagnostic accuracy of 60.21%. USG had the lowest sensitivity of 49.36% with a diagnostic accuracy of 51.6%. 4D-CT had the highest sensitivity of 82.72%, a specificity of 56% and a diagnostic accuracy of 76.42%. When SPECT/CT was used in combination with USG the sensitivity was significantly higher (p=0.0001) at 69.54% and when SPECT/CT was used in combination with 4D-CT the sensitivity was significantly higher at 91.4% (p=0.0001).ConclusionsSPECT/CT was more sensitive and accurate as compared to USG but when they were used together the sensitivity was significantly higher. Superior preoperative localization was provided by 4D-CT as compared to SPECT/CT.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.29015