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Parathyroid 4D CT and Scintigraphy: What Factors Contribute to Missed Parathyroid Lesions?

Publication ,  Journal Article
Galvin, L; Oldan, JD; Bahl, M; Eastwood, JD; Sosa, JA; Hoang, JK
Published in: Otolaryngol Head Neck Surg
May 2016

OBJECTIVE: To determine the prevalence of missed lesions for parathyroid 4-dimensional computed tomography (4D CT) and scintigraphy and to describe the factors leading to missed lesions for both modalities. STUDY DESIGN: Case series with chart review. SETTING: Single center, hospital based. SUBJECTS AND METHODS: Forty patients undergoing 4D CT and scintigraphy before parathyroidectomy between July 2009 and October 2013 were included. Radiology reports and imaging were reviewed and correlated with operative notes to identify cases with missed lesions and the reasons for those misses. All lesions were then classified according to the following factors: multigland disease, lesion size, patient body weight, and multinodular goiter. RESULTS: Of the 40 patients, 6 had multigland disease, resulting in 51 lesions; 12 and 29 lesions were missed on 4D CT and scintigraphy, respectively. The sensitivity for detection of all lesions was 76% for 4D CT and 43% for scintigraphy. Sensitivities for single-gland disease were 88% for 4D CT and 50% for scintigraphy. Sensitivities for multigland disease were 53% for 4D CT and 24% for scintigraphy. Rates of multigland disease in patients with missed lesions were 75% on 4D CT and 48% on scintigraphy, as compared with patients with detected lesions, 23% and 18%, respectively (P ≤ .04). Mean weight of lesions missed on 4D CT was 0.3 and 0.6 g in detected lesions (P = .15). Mean weight of lesions missed on scintigraphy was 0.4 and 0.8 g in detected lesions (P = .03). CONCLUSION: 4D CT has higher sensitivity than scintigraphy. Missed lesions are more likely to occur with multigland disease for both modalities and in smaller lesions for scintigraphy.

Duke Scholars

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Published In

Otolaryngol Head Neck Surg

DOI

EISSN

1097-6817

Publication Date

May 2016

Volume

154

Issue

5

Start / End Page

847 / 853

Location

England

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Sensitivity and Specificity
  • Radiopharmaceuticals
  • Parathyroidectomy
  • Parathyroid Diseases
  • Otorhinolaryngology
  • Middle Aged
  • Male
  • Humans
  • Four-Dimensional Computed Tomography
 

Citation

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Galvin, L., Oldan, J. D., Bahl, M., Eastwood, J. D., Sosa, J. A., & Hoang, J. K. (2016). Parathyroid 4D CT and Scintigraphy: What Factors Contribute to Missed Parathyroid Lesions? Otolaryngol Head Neck Surg, 154(5), 847–853. https://doi.org/10.1177/0194599816630711
Galvin, Leo, Jorge D. Oldan, Manisha Bahl, James D. Eastwood, Julie A. Sosa, and Jenny K. Hoang. “Parathyroid 4D CT and Scintigraphy: What Factors Contribute to Missed Parathyroid Lesions?Otolaryngol Head Neck Surg 154, no. 5 (May 2016): 847–53. https://doi.org/10.1177/0194599816630711.
Galvin L, Oldan JD, Bahl M, Eastwood JD, Sosa JA, Hoang JK. Parathyroid 4D CT and Scintigraphy: What Factors Contribute to Missed Parathyroid Lesions? Otolaryngol Head Neck Surg. 2016 May;154(5):847–53.
Galvin, Leo, et al. “Parathyroid 4D CT and Scintigraphy: What Factors Contribute to Missed Parathyroid Lesions?Otolaryngol Head Neck Surg, vol. 154, no. 5, May 2016, pp. 847–53. Pubmed, doi:10.1177/0194599816630711.
Galvin L, Oldan JD, Bahl M, Eastwood JD, Sosa JA, Hoang JK. Parathyroid 4D CT and Scintigraphy: What Factors Contribute to Missed Parathyroid Lesions? Otolaryngol Head Neck Surg. 2016 May;154(5):847–853.
Journal cover image

Published In

Otolaryngol Head Neck Surg

DOI

EISSN

1097-6817

Publication Date

May 2016

Volume

154

Issue

5

Start / End Page

847 / 853

Location

England

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Sensitivity and Specificity
  • Radiopharmaceuticals
  • Parathyroidectomy
  • Parathyroid Diseases
  • Otorhinolaryngology
  • Middle Aged
  • Male
  • Humans
  • Four-Dimensional Computed Tomography