Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography

Steven E. Rodgers; George J. Hunter; Leena M. Hamberg; Dawid Schellingerhout; David B. Doherty; Gregory D. Ayers; Suzanne E. Shapiro; Beth S. Edeiken; Mylene T. Truong; Douglas B. Evans; Jeffrey E. Lee; Nancy D. Perrier

doi:10.1016/j.surg.2006.07.028

Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography

Steven E. Rodgers, George J. Hunter, Leena M. Hamberg, Dawid Schellingerhout, David B. Doherty, Gregory D. Ayers, Suzanne E. Shapiro, Beth S. Edeiken, Mylene T. Truong, Douglas B. Evans, Jeffrey E. Lee, Nancy D. Perrier

Research output: Contribution to journal › Article › peer-review

276 Scopus citations

Abstract

Background: Four-dimensional computed tomography (4D-CT) provides both functional and highly detailed anatomic information about parathyroid tumors. The purpose of this study was to compare 4D-CT with sestamibi imaging and ultrasonography as methods for the accurate preoperative localization of hyperfunctioning parathyroid glands before parathyroidectomy. Methods: A study of 75 patients with primary hyperparathyroidism was performed at a tertiary-care institution. Sestamibi imaging, ultrasonography, and 4D-CT were performed on each patient preoperatively. Results of the imaging studies were compared with operative findings, pathologic data, and biochemical measurements to assess the sensitivity and specificity of each of the imaging modalities. Results: 4D-CT demonstrated improved sensitivity (88%) over sestamibi imaging (65%) and ultrasonography (57%), when the imaging studies were used to localize (lateralize) hyperfunctioning parathyroid glands to 1 side of the neck. Moreover, when used to localize parathyroid tumors to the correct quadrant of the neck (ie, right inferior, right superior, left inferior, or left superior), the sensitivity of 4D-CT (70%) was significantly higher than sestamibi imaging (33%) and ultrasonography (29%). Conclusion: 4D-CT provides significantly greater sensitivity than sestamibi imaging and ultrasonography for precise (quadrant) localization of hyperfunctioning parathyroid glands. This allows improved preoperative planning, particularly for the case of reoperation. In addition to the data that are provided, we present a novel classification scheme for use in parathyroid localization.

Original language	English (US)
Pages (from-to)	932-941
Number of pages	10
Journal	Surgery
Volume	140
Issue number	6
DOIs	https://doi.org/10.1016/j.surg.2006.07.028
State	Published - Dec 2006
Externally published	Yes

ASJC Scopus subject areas

Surgery

Access to Document

10.1016/j.surg.2006.07.028

Cite this

Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography. / Rodgers, Steven E.; Hunter, George J.; Hamberg, Leena M.; Schellingerhout, Dawid; Doherty, David B.; Ayers, Gregory D.; Shapiro, Suzanne E.; Edeiken, Beth S.; Truong, Mylene T.; Evans, Douglas B.; Lee, Jeffrey E.; Perrier, Nancy D.

In: Surgery, Vol. 140, No. 6, 12.2006, p. 932-941.

Research output: Contribution to journal › Article › peer-review

Rodgers, Steven E. ; Hunter, George J. ; Hamberg, Leena M. ; Schellingerhout, Dawid ; Doherty, David B. ; Ayers, Gregory D. ; Shapiro, Suzanne E. ; Edeiken, Beth S. ; Truong, Mylene T. ; Evans, Douglas B. ; Lee, Jeffrey E. ; Perrier, Nancy D. / Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography. In: Surgery. 2006 ; Vol. 140, No. 6. pp. 932-941.

@article{1184c6b9d82e42bfa57e88efe17ff110,

title = "Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography",

abstract = "Background: Four-dimensional computed tomography (4D-CT) provides both functional and highly detailed anatomic information about parathyroid tumors. The purpose of this study was to compare 4D-CT with sestamibi imaging and ultrasonography as methods for the accurate preoperative localization of hyperfunctioning parathyroid glands before parathyroidectomy. Methods: A study of 75 patients with primary hyperparathyroidism was performed at a tertiary-care institution. Sestamibi imaging, ultrasonography, and 4D-CT were performed on each patient preoperatively. Results of the imaging studies were compared with operative findings, pathologic data, and biochemical measurements to assess the sensitivity and specificity of each of the imaging modalities. Results: 4D-CT demonstrated improved sensitivity (88%) over sestamibi imaging (65%) and ultrasonography (57%), when the imaging studies were used to localize (lateralize) hyperfunctioning parathyroid glands to 1 side of the neck. Moreover, when used to localize parathyroid tumors to the correct quadrant of the neck (ie, right inferior, right superior, left inferior, or left superior), the sensitivity of 4D-CT (70%) was significantly higher than sestamibi imaging (33%) and ultrasonography (29%). Conclusion: 4D-CT provides significantly greater sensitivity than sestamibi imaging and ultrasonography for precise (quadrant) localization of hyperfunctioning parathyroid glands. This allows improved preoperative planning, particularly for the case of reoperation. In addition to the data that are provided, we present a novel classification scheme for use in parathyroid localization.",

author = "Rodgers, {Steven E.} and Hunter, {George J.} and Hamberg, {Leena M.} and Dawid Schellingerhout and Doherty, {David B.} and Ayers, {Gregory D.} and Shapiro, {Suzanne E.} and Edeiken, {Beth S.} and Truong, {Mylene T.} and Evans, {Douglas B.} and Lee, {Jeffrey E.} and Perrier, {Nancy D.}",

note = "Funding Information: Supported in part by research funds from the Hamill Foundation and from the Department of Diagnostic Radiology at The University of Texas M.D. Anderson Cancer Center. Copyright: Copyright 2008 Elsevier B.V., All rights reserved.",

year = "2006",

month = dec,

doi = "10.1016/j.surg.2006.07.028",

language = "English (US)",

volume = "140",

pages = "932--941",

journal = "Surgery (United States)",

issn = "0039-6060",

publisher = "Mosby Inc.",

number = "6",

}

TY - JOUR

T1 - Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography

AU - Rodgers, Steven E.

AU - Hunter, George J.

AU - Hamberg, Leena M.

AU - Schellingerhout, Dawid

AU - Doherty, David B.

AU - Ayers, Gregory D.

AU - Shapiro, Suzanne E.

AU - Edeiken, Beth S.

AU - Truong, Mylene T.

AU - Evans, Douglas B.

AU - Lee, Jeffrey E.

AU - Perrier, Nancy D.

N1 - Funding Information: Supported in part by research funds from the Hamill Foundation and from the Department of Diagnostic Radiology at The University of Texas M.D. Anderson Cancer Center. Copyright: Copyright 2008 Elsevier B.V., All rights reserved.

PY - 2006/12

Y1 - 2006/12

N2 - Background: Four-dimensional computed tomography (4D-CT) provides both functional and highly detailed anatomic information about parathyroid tumors. The purpose of this study was to compare 4D-CT with sestamibi imaging and ultrasonography as methods for the accurate preoperative localization of hyperfunctioning parathyroid glands before parathyroidectomy. Methods: A study of 75 patients with primary hyperparathyroidism was performed at a tertiary-care institution. Sestamibi imaging, ultrasonography, and 4D-CT were performed on each patient preoperatively. Results of the imaging studies were compared with operative findings, pathologic data, and biochemical measurements to assess the sensitivity and specificity of each of the imaging modalities. Results: 4D-CT demonstrated improved sensitivity (88%) over sestamibi imaging (65%) and ultrasonography (57%), when the imaging studies were used to localize (lateralize) hyperfunctioning parathyroid glands to 1 side of the neck. Moreover, when used to localize parathyroid tumors to the correct quadrant of the neck (ie, right inferior, right superior, left inferior, or left superior), the sensitivity of 4D-CT (70%) was significantly higher than sestamibi imaging (33%) and ultrasonography (29%). Conclusion: 4D-CT provides significantly greater sensitivity than sestamibi imaging and ultrasonography for precise (quadrant) localization of hyperfunctioning parathyroid glands. This allows improved preoperative planning, particularly for the case of reoperation. In addition to the data that are provided, we present a novel classification scheme for use in parathyroid localization.

AB - Background: Four-dimensional computed tomography (4D-CT) provides both functional and highly detailed anatomic information about parathyroid tumors. The purpose of this study was to compare 4D-CT with sestamibi imaging and ultrasonography as methods for the accurate preoperative localization of hyperfunctioning parathyroid glands before parathyroidectomy. Methods: A study of 75 patients with primary hyperparathyroidism was performed at a tertiary-care institution. Sestamibi imaging, ultrasonography, and 4D-CT were performed on each patient preoperatively. Results of the imaging studies were compared with operative findings, pathologic data, and biochemical measurements to assess the sensitivity and specificity of each of the imaging modalities. Results: 4D-CT demonstrated improved sensitivity (88%) over sestamibi imaging (65%) and ultrasonography (57%), when the imaging studies were used to localize (lateralize) hyperfunctioning parathyroid glands to 1 side of the neck. Moreover, when used to localize parathyroid tumors to the correct quadrant of the neck (ie, right inferior, right superior, left inferior, or left superior), the sensitivity of 4D-CT (70%) was significantly higher than sestamibi imaging (33%) and ultrasonography (29%). Conclusion: 4D-CT provides significantly greater sensitivity than sestamibi imaging and ultrasonography for precise (quadrant) localization of hyperfunctioning parathyroid glands. This allows improved preoperative planning, particularly for the case of reoperation. In addition to the data that are provided, we present a novel classification scheme for use in parathyroid localization.

UR - http://www.scopus.com/inward/record.url?scp=33845578989&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845578989&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2006.07.028

DO - 10.1016/j.surg.2006.07.028

M3 - Article

C2 - 17188140

AN - SCOPUS:33845578989

VL - 140

SP - 932

EP - 941

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 6

ER -

Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this