SENSITIVITY AND SPECIFICITY OF DIFFERENT RADIOLOGICAL LOCALISATION STUDIES FOR PRIMARY HYPERPARATHYROIDISM: A SYSTEMATIC REVIEW

AUTHORS:
Y. Al-Mukhaizeem (Cork, Ireland) , S. Kemp (Cork, Ireland) , R. Carrillo (Cork, Ireland) , H. Al-Harthi (Cork, Ireland) , S. O'Connor (Cork, Ireland) , R.Y. Teo (Cork, Ireland) , B. O'Flynn (Cork, Ireland) , S. Rupani (Cork, Ireland) , A. Mehmood (Cork, Ireland) , S. Paul (Cork, Ireland) , P. Redmond (Cork, Ireland)
Background:
The increasing use of minimally invasive surgical techniques in patients with primary hyperparathyroidism has emphasized the importance of precise localization of parathyroid lesions to avoid four-gland exploration. Numerous imaging modalities have been used for this purpose, however to date there is no consensus on the optimal radiological studies for localising parathyroid adenomas. We aim to conduct a systematic review to determine the sensitivity and specificity of different radiological localisation studies for patients with primary hyperparathyroidism.
Methods:
We performed a search of Embase, Pubmed, and Scopus databases to identify studies published between January 2018 to November 2023 investigating the sensitivity and specificity of ultrasonography, sestamibi, and 4D computed tomography for parathyroid localization in patients with a biochemical diagnosis of primary hyperparathyroidism.
Results:
A total of forty-five studies were included in the evaluation. The overall pooled sensitivity and specificity for each imaging modality were 61.75% and 80.5% for ultrasonography, 65.7% and 74.8% for sestamibi, and 84.1% and 82.5% for 4D computed tomography respectively.
Conclusions:
Overall, 4D computed tomography showed superior pre-operative sensitivity and specificity in comparison to the other radiological modalities and may be considered as first line imaging for localizing parathyroid adenomas in the setting of primary hyperparathyroidism.