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Preoperative Parathyroid Imaging: Trends in Utilization and Comparative Accuracy of Sonography, Scintigraphy, and
1From the Department of Radiology, Duke University Medical Center, Durham, NC.
Objective:
The purposes of this study were to describe trends in parathyroid imaging utilization and to compare the sensitivities of sonography, scintigraphy, and 4-dimensional computed tomography (4DCT) in different imaging algorithms.
Methods:
A retrospective review of consecutive patients who underwent parathyroid surgery from 2009 to 2014 was performed. Utilization and accuracy were compared for sonography, scintigraphy, and 4DCT.
Results:
The study population was composed of 604 patients with 850 adenomas or hyperplastic glands. Sonography was the most common imaging modality, performed in 91.2% (551/604) of patients. The utilization of 4DCT increased in the study period from 1.5% (2/133) in 2009-2010 to 75.8% (72/95) in 2013-2014 (P < 0.01). The overall sensitivities of sonography, scintigraphy, and 4DCT, regardless of order of imaging or imaging algorithm, were 58.6% (456/778), 49.1% (317/645), and 82.3% (121/147), respectively (P < 0.01).
Conclusions:
Four-dimensional CT has the highest sensitivity for localization of parathyroid adenomas regardless of order of imaging or imaging algorithm.
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