{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:06:15Z","timestamp":1791324375718,"version":"4.3.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["EJNMMI Rep."],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>To determine the use of four-dimensional CT as first-line imaging compared to the traditional combination of ultrasound and [<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Retrospective review of preoperative imaging in patients with primary hyperparathyroidism, who underwent parathyroidectomy between 2012 and 2021. In one group, the combination ultrasound and [<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT was used as first-line imaging (<jats:italic>n<\/jats:italic>\u2009=\u200954), in the other group four-dimensional CT was the first-line imaging modality (<jats:italic>n<\/jats:italic>\u2009=\u200951). Sensitivity and positive predictive value were calculated on patient, lateralisation and localisation level. The need for additional imaging was also assessed for both groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Four-dimensional CT had a significantly higher sensitivity compared to the combination of ultrasound\/[<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT on patient and localisation level (70.6% vs. 51.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.049 and 60.8% vs. 35.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.009 respectively). Sensitivity for lateralisation also appeared higher, but did not reach significance (62.7% vs. 44.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.060). Positive predictive value was not significantly higher for four-dimensional CT compared to ultrasound and [<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT (88.9% vs. 85.7% for lateralisation and 86.1% vs. 67.9% for localisation respectively). Additional imaging was required in 14 patients with four-dimensional CT as first-line imaging (27.4%) consisting of 2 ultrasound\/[<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT and 13 [<jats:sup>18<\/jats:sup>F]fluorocholine PET\/CT, compared to 24 patients with ultrasound\/[<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT as first-line imaging (44.4%), requiring 22 four-dimensional CT and 9 [<jats:sup>18<\/jats:sup>F]fluorocholine PET\/CT.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Four-dimensional CT as the sole first-line parathyroid imaging modality had higher sensitivity than the combination of ultrasound and [<jats:sup>99m<\/jats:sup>Tc]Tc-Sestamibi SPECT, therefore requiring fewer additional procedures. Although the most costly, [<jats:sup>18<\/jats:sup>F]fluorocholine PET\/CT was the most effective technique to localise parathyroid adenoma in case all other imaging was negative.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s41824-024-00198-5","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:02:12Z","timestamp":1714521732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Four-dimensional computed tomography as first-line imaging in primary hyperparathyroidism, a retrospective comparison to conventional imaging in a predominantly single adenoma population"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3502-5270","authenticated-orcid":false,"given":"Jorian P.","family":"Krol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank B.M.","family":"Joosten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Louise E.","family":"Bernsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis H.","family":"Slump","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim J.G.","family":"Oyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,1]]},"reference":[{"issue":"6","key":"198_CR13","first-page":"e4960","volume":"11","author":"W Abd Elhameed Elsayed","year":"2019","unstructured":"Abd Elhameed Elsayed W, Ali RA (2019) Efficacy of Scintigraphy, Ultrasound and both Scintigraphy and Ultrasonography in Preoperative Detection and localization of primary hyperparathyroidism. 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