TY - JOUR
T1 - Four-dimensional computed tomography (4D-CT) for preoperative parathyroid localization
T2 - A good study but are we using it?
AU - Kuo, Lindsay E.
AU - Bird, Sarah H.
AU - Lubitz, Carrie C.
AU - Pandian, T. K.
AU - Parangi, Sareh
AU - Stephen, Antonia E.
N1 - Funding Information:
No grant funding was utilized with respect to this research.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - 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.
AB - 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.
KW - 4D-CT
KW - CESQIP
KW - Preoperative localization
KW - Primary hyperparathyroidism
KW - Sestamibi
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85115771701&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2021.09.015
DO - 10.1016/j.amjsurg.2021.09.015
M3 - Article
C2 - 34579935
AN - SCOPUS:85115771701
SN - 0002-9610
VL - 223
SP - 694
EP - 698
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -