Source: DGNews  |  Posted 5 years ago

By Crystal Phend

SAN DIEGO, C.A. -- March 29, 2006 -- Four-dimensional computed tomography (4D-CT) provides detailed identification and localization of diseased parathyroid glands, according to a study presented here at the annual meeting of the Society of Surgical Oncology (SSO).

Accurate localization of the gland with primary hyperparathyroidism is critical for successful minimally invasive parathyroidectomy. 4D-CT is a new imaging modality that reconstructs 3-dimensional CT images to account for time as the radioactive isotope rapidly washes in and out of the gland.

"It is ideally suited to the minimally invasive parathyroidectomy procedure," said lead author Steven E. Rogers, MD, PhD, surgical oncology fellow, University of Texas M.D. Anderson Cancer Center, Houston, Texas, United States, in a presentation March 24[^]th[]. "It allows improved preoperative planning."

In the study, 60 patients with biochemically confirmed primary hyperparathyroidism underwent 4D-CT. The majority of patients (51) had single-gland disease and 9 had double-gland involvement.

4D-CT correctly identified the correct side in 82% of subjects with one affected gland and 66.7% of subjects with multiglandular disease. Dr. Rogers said that 4D-CT technology had a sensitivity of 87% and a specificity of 85%, similar to ultrasound and sestamibi localization.

He said that one reason sensitivity was not higher was because they are seeing more large glands than ever before and another may be the learning curve for reading and performing the scans.

Precise anatomical location was correctly identified in 71% of 51 subjects, with a sensitivity of 68% and specificity of 85%.

"4D-CT provides both functional and anatomical visualization of structures in the neck," Dr. Rogers said, which allows better planning for surgery, especially in patients undergoing re-operation.

Although 4D-CT is now used with sestamibi single photon emission CT (SPECT) imaging, he said it might be possible to use it as the sole imaging modality in the future. "This is still better than sestamibi SPECT," Dr. Rogers added.

[Presentation title: Four-Dimensional Computed Tomography: A Novel Imaging Modality for Localization of Parathyroid Tumors. Session 41]