Parathyroid Imaging Practices for Primary Hyperparathyroidism Without Previous Operations Among Endocrine Surgery...

Area of Science:

• Endocrinology
• Surgical Oncology
• Medical Imaging

Background:

• Preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism (pHPT) utilizes various imaging modalities.
• Surgeon-specific study utilization and variable opinions in parathyroid surgery contribute to management heterogeneity.
• Increasing pHPT diagnoses highlight the need to understand current imaging practices.

Purpose of the Study:

• To investigate the preoperative parathyroid imaging practices among endocrine surgeons.
• To identify variations in imaging test choices within individual surgical practices.
• To assess the influence of clinical support teams on imaging recommendations.

Main Methods:

• An email-based survey was sent to program directors of 22 American Association of Endocrine Surgeons fellowship programs.
• The survey queried the initial diagnostic test of choice for pHPT.
• Clinical support team members were contacted to compare their recommendations with those of their institution's endocrine surgeons.

Main Results:

• 68% of clinical team members recommended different or additional imaging tests compared to their institution's endocrine surgeon.
• Neck ultrasound was the most common initial imaging test repeated by both surgeons and clinical team members.
• 33% of clinical team members agreed with their surgeon's initial ultrasound recommendation.

Conclusions:

• Significant variability exists in preoperative imaging for hyperparathyroidism.
• Inconsistency in imaging recommendations extends within individual surgical practices due to clinical support team influence.
• Improved clinical protocols are needed to standardize preoperative imaging within institutions.