The following is a summary of “Use of dual energy computed tomography versus conventional techniques for preoperative localization in primary hyperparathyroidism: Effect of preoperative calcium and parathyroid hormone levels,” published in the MAY 2023 issue of Surgery by Guo, et al.

For a study, researchers sought to investigate the association between preoperative calcium and parathyroid hormone (PTH) levels and the sensitivity and accuracy of three preoperative localization techniques: dual-energy computed tomography (DECT), single-photon emission CT with 99mTc-sestamibi (CT-MIBI), and ultrasound (US) in patients with primary hyperparathyroidism (PHP).

The study included patients who underwent parathyroidectomy for PHP at a tertiary care facility between 2012 and 2021. These patients underwent DECT, CT-MIBI, and US for preoperative localization. The patients were stratified based on their preoperative calcium and PTH levels.

A total of 278 patients were included in the study. Among patients with high calcium and PTH levels, DECT showed higher sensitivity (87.7%) and accuracy (85.2%) compared to CT-MIBI (82.3%, 79.0%) and the US (61.7%, 53.1%). DECT was more sensitive and accurate than other preoperative localization techniques in subgroups with normal PTH levels (sensitivity: 60.9%, accuracy: 52.1%) and normal calcium levels (sensitivity: 41.7%, accuracy: 33.3%).

Preoperative calcium and PTH levels were associated with the sensitivity and accuracy of preoperative localization in patients with PHP. DECT demonstrated higher sensitivity and accuracy compared to other first-line imaging techniques. The findings suggested that DECT may be a valuable tool for preoperative localization in PHP patients.

Source: americanjournalofsurgery.com/article/S0002-9610(23)00017-X/fulltext