{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:18:26Z","timestamp":1788387506487,"version":"build-2803163510"},"reference-count":19,"publisher":"Royal College of Surgeons of England","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Four-dimensional computed tomography (4DCT) has emerged as an effective imaging modality to aid parathyroid localisation before surgery. Following a service change in 2018, we evaluated the accuracy of 4DCT to lateralise culprit parathyroid glands causing primary hyperparathyroidism (PHPT) in patients undergoing parathyroid surgery in our centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 117 patients underwent 4DCT before parathyroidectomy for PHPT in NHS Grampian between March 2018 and January 2023, of whom 112 underwent first-time operations. Results of imaging, histopathology and surgery type along with biochemical follow-up were evaluated retrospectively to assess the sensitivity and specificity of 4DCT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our centre, 4DCT imaging showed results comparable with those reported previously, with 77.6% sensitivity to lateralise to one side of the neck, 89.1% specificity and an overall accuracy of 83.5%. A total of 58% of patients underwent targeted parathyroidectomy. At three- to six-month follow-up, 94.5% had achieved biochemical cure; 4DCT identified culprit lesions in four out of five patients undergoing reoperation. Age and corrected calcium did not affect accuracy of 4DCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>4DCT is an effective first-line imaging modality before first-time parathyroidectomy for PHPT in patients aged &gt;60 years as well as in cases of reoperation. Use as the first-line imaging modality in younger patients may reduce overall radiation exposure by minimising the need for additional imaging, but further study is needed in this age group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1308\/rcsann.2025.0062","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T14:22:28Z","timestamp":1762870948000},"page":"518-523","source":"Crossref","is-referenced-by-count":1,"title":["Use of four-dimensional computed tomography to aid parathyroid localisation in primary hyperparathyroidism in British surgical practice"],"prefix":"10.1308","volume":"108","author":[{"given":"N","family":"Sawhney","sequence":"first","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Findlater","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Hussain","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Rajan","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospital, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"McAteer","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Abraham","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Graveling","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Aspinall","sequence":"additional","affiliation":[{"name":"Aberdeen Royal Infirmary","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"171","reference":[{"key":"C1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31430-7"},{"key":"C2","doi-asserted-by":"publisher","DOI":"10.1016\/j.soc.2015.08.012"},{"key":"C3","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/3108395"},{"key":"C4","doi-asserted-by":"publisher","DOI":"10.1007\/s12149-007-0086-z"},{"key":"C5","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-1507-0"},{"key":"C6","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2006.07.028"},{"key":"C7","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2018.0158"},{"key":"C8","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-1870-5"},{"key":"C9","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1365-3"},{"key":"C10","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.13278"},{"key":"C11","unstructured":"National Institute for Health and Care Excellence. Hyperparathyroidism (primary): diagnosis, assessment and initial management [NG132]. Issued May 2019. https:\/\/www.nice.org.uk\/guidance\/NG132 (cited July 2025)."},{"key":"C12","first-page":"6614406","volume":"2021","author":"Raeymaeckers S","year":"2021","journal-title":"Radiol Res Pract"},{"key":"C13","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6367-z"},{"key":"C14","volume-title":"Sixth National Audit Report, British Association of Endocrine and Thyroid Surgeons 2021","author":"Aspinall S","year":"2021"},{"key":"C15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2017.01.004"},{"key":"C16","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16924"},{"key":"C17","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816630711"},{"key":"C18","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2017.0014"},{"key":"C19","doi-asserted-by":"publisher","DOI":"10.1308\/003588412X13171221498389"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/rcsann.2025.0062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:11:25Z","timestamp":1788387085000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/rcsann.2025.0062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1308\/rcsann.2025.0062"],"URL":"https:\/\/doi.org\/10.1308\/rcsann.2025.0062","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}