The diagnostic accuracy of neck ultrasound, 4D-Computed tomographyand sestamibi imaging in parathyroid carcinoma |
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| Affiliation: | 1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;2. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;3. Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;5. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;6. Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, TX, USA;1. Centre for Applied Biomedical Engineering Research (CABER), Health Research Institute (HRI), School of Engineering, Bernal Institute, University of Limerick, Lonsdale Building, Limerick, Ireland;2. Department of Radiology, University Hospital Limerick, Ireland;3. Department of Vascular Surgery, University Hospital Limerick, Ireland;1. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;2. Department of Diagnostic Imaging and Interventional Radiology, Kyoto Katsura Hospital, 17 Yamada-Hirao, Nishikyo-ku, Kyoto 615-8256, Japan;1. Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany;2. Department of Urology, Central Hospital of Bolzano, Bolzano, Italy;1. Capital Medical University, Beijing Friendship Hospital, Department of Nuclear Medicine, 95, Yong An Road, Xi Cheng district, 100050 Beijing, People''s Republic of China;2. Capital Medical University, Beijing Friendship Hospital, Radiology Department, 95, Yong An Road, Xi Cheng district, 100050 Beijing, People''s Republic of China;1. Department of Pathology, Molecular Pathology Research Centre, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100730, China;2. Clinical Biobank, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China;3. Department of Pathology, Affiliated Hospital of Hebei University, Baoding, 071000, China;1. Department of Surgical Oncology, Institute of Oncology Ljubljana, Slovenia;2. Department of Nuclear Medicine, University Medical Centre Ljubljana, Slovenia;3. Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Slovenia |
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| Abstract: | ![]()
IntroductionOur aim was to investigate the accuracy of available imaging modalities for parathyroid carcinoma (PC) in our institution and to identify which imaging modality, or combination thereof, is optimal in preoperative determination of precise tumor location.MethodsAll operated PC patients in our institution between 2000 and 2015 that had at least one of the following in-house preoperative scans: neck ultrasonography (US), neck 4D-Computed Tomography (4DCT) and 99mTc Sestamibi SPECT/CT (MIBI). Sensitivity, specificity and accuracy of PC tumor localization were assessed individually and in combination.Results20 patients fulfilled the inclusion criteria and were analysed. There were 18 US, 18 CT and 9 MIBI scans. The sensitivity and accuracy for tumor localisation of US was 80% (CI 56–94%) and 73% respectively, of 4DCT was 79% (CI 58–93%) and 82%, and of MIBI was 81% (CI 54–96%) and 78%. The sensitivity and accuracy of the combination of CT and MIBI was 94% (CI 73–100%) and 95% and for the combination of US, CT and MIBI was 100% (CI 72–100%) and 100% respectively. The wash-out of the PC lesions, expressed as a percentage change in Hounsfield Units from the arterial phase to early delayed phase was −9.29% and to the late delayed phase was −16.88% (n = 11).ConclusionsThe sensitivity of solitary preoperative imaging of PC patients, whether by US, CT or MIBI, is approximately 80%. Combinations of CT with MIBI and US increase the sensitivity to 95% or better. Combined preoperative imaging of patients with clinical possibility of PC is therefore recommended. |
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| Keywords: | Parathyroid CT MR Ultrasound Cancer Head and neck |
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