Diagnostic Performance of Four-Dimensional CT in Preoperative Localization of Primary Hyperparathyroidism.
10.3881/j.issn.1000-503X.16069
- Author:
Man WANG
1
;
Yun WANG
1
;
Zhu-Hua ZHANG
1
;
Su TONG
1
;
Yu CHEN
1
;
Zheng-Yu JIN
1
Author Information
1. Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
- Publication Type:Journal Article
- Keywords:
four-dimensional CT;
preoperative localization;
primary hyperparathyroidism
- MeSH:
Humans;
Hyperparathyroidism, Primary/surgery*;
Retrospective Studies;
Four-Dimensional Computed Tomography;
Male;
Female;
Middle Aged;
Adult;
Aged;
Parathyroid Glands/diagnostic imaging*;
Preoperative Period
- From:
Acta Academiae Medicinae Sinicae
2025;47(1):42-47
- CountryChina
- Language:English
-
Abstract:
Objective To evaluate the application value of four-dimensional CT(4D-CT)in the preoperative localization of primary hyperparathyroidism(PHPT). Methods A retrospective analysis was conducted on the clinical data and parathyroid 4D-CT images of 63 patients who underwent PHPT surgery at Peking Union Medical College Hospital between April 2020 and April 2023.Based on the clinical experience of the hospital's surgeons,parathyroid lesions were categorized into six anatomical regions:around the upper pole of the thyroid,posterior to the mid-thyroid,posterior to the lower pole of the thyroid and the tracheoesophageal groove,below the lower pole of the thyroid and the suprasternal fossa,retrosternal anterior mediastinum,and other rare locations.All images were independently analyzed by two experienced radiologists,with discrepancies resolved through discussion led by a senior radiologist.Using pathological results as the gold standard,the accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),Youden index,positive likelihood ratio(PLR),and negative likelihood ratio(NLR)of preoperative 4D-CT in diagnosing PHPT were calculated. Results There were no statistically significant differences between preoperative 4D-CT and surgical localization in the following regions:around the upper pole of the thyroid(χ2=0.500,P=0.480),posterior to the mid-thyroid(χ2<0.001,P>0.999),posterior to the lower pole of the thyroid and the tracheoesophageal groove(χ2=0.571,P=0.450),below the lower pole of the thyroid and the suprasternal fossa(χ2<0.001,P>0.999),retrosternal anterior mediastinum(χ2<0.001,P>0.999),and other rare locations(χ2<0.001,P>0.999).The preoperative 4D-CT diagnosis of PHPT lesions demonstrated a sensitivity of 82.09%,specificity of 97.43%,PPV of 87.30%,NPV of 96.19%,accuracy of 94.71%,Youden index of 79.52%,PLR of 31.94,and NLR of 0.18. Conclusion Parathyroid 4D-CT demonstrates good diagnostic efficacy in the preoperative localization of PHPT.
