Validation of a novel method for localization of parathyroid adenomas using SPECT/CT
Abstract Background Accurate localization of parathyroid adenomas is of critical importance in surgical planning for minimally invasive parathyroidectomy. SPECT/CT is considered the investigation of choice but has limitations regarding localization of superior versus inferior adenomas. We proposed a...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2018-10-01
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| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Online Access: | http://link.springer.com/article/10.1186/s40463-018-0307-6 |
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| author | Rachelle A. LeBlanc Andre Isaac Jonathan Abele Vincent L. Biron David W. J. Côté Matthew Hearn Daniel A. O’Connell Hadi Seikaly Jeffrey R. Harris |
| author_facet | Rachelle A. LeBlanc Andre Isaac Jonathan Abele Vincent L. Biron David W. J. Côté Matthew Hearn Daniel A. O’Connell Hadi Seikaly Jeffrey R. Harris |
| author_sort | Rachelle A. LeBlanc |
| collection | DOAJ |
| description | Abstract Background Accurate localization of parathyroid adenomas is of critical importance in surgical planning for minimally invasive parathyroidectomy. SPECT/CT is considered the investigation of choice but has limitations regarding localization of superior versus inferior adenomas. We proposed a novel method for localization using SPECT/CT by determining the anterior-posterior relationship of the adenoma to a horizontal line in the coronal plane through the tracheoesophageal groove. Our objective was to determine the accuracy, validity, and inter-rater reliability of this method. Method This was a retrospective review of patients who underwent parathyroidectomy for a single adenoma between 2010-2017. SPECT/CT images were reviewed by two staff Otolaryngologists, a Radiologist, an Otolaryngology fellow and Otolaryngology resident. Results were compared using intra-operative report as the gold standard. Overall accuracy in determining superior/inferior and right/left adenomas was calculated, as well as Cohen's Kappa to determine agreement with operative report and inter-rater reliability. The performance was compared to that of the original radiology report. Results One hundred thirty patients met criteria and were included. Our method correctly identified the location of the adenoma in terms of both side and superior/inferior position in 80.4% [76 - 84%] of patients, which considerably outperformed the original radiology report at 48.5% [4-78%] accuracy. The agreement level between our method and operative report was high (Kappa=0.717 [0.691-0.743]), as was the inter-rater reliability (Kappa=0.706 [0.674-0.738]). Conclusion We report a novel method for localization of parathyroid adenomas using SPECT/CT which outperforms standard radiology reporting. This tool can be used by surgeons and radiologists to better inform and plan for minimally invasive parathyroidectomy. |
| format | Article |
| id | doaj-art-84f6f73bef5a4a38be188d58e82b6066 |
| institution | Kabale University |
| issn | 1916-0216 |
| language | English |
| publishDate | 2018-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-84f6f73bef5a4a38be188d58e82b60662025-02-02T23:08:46ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162018-10-014711610.1186/s40463-018-0307-6Validation of a novel method for localization of parathyroid adenomas using SPECT/CTRachelle A. LeBlanc0Andre Isaac1Jonathan Abele2Vincent L. Biron3David W. J. Côté4Matthew Hearn5Daniel A. O’Connell6Hadi Seikaly7Jeffrey R. Harris8Division of Otolaryngology—Head and Neck Surgery, University of AlbertaDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaDepartment of Radiology & Diagnostic Imaging, Royal Alexandra Hospital, 1046 Royal Alexandra Hospital – Diagnostic Treatment CenterDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaDivision of Otolaryngology—Head and Neck Surgery, University of AlbertaAbstract Background Accurate localization of parathyroid adenomas is of critical importance in surgical planning for minimally invasive parathyroidectomy. SPECT/CT is considered the investigation of choice but has limitations regarding localization of superior versus inferior adenomas. We proposed a novel method for localization using SPECT/CT by determining the anterior-posterior relationship of the adenoma to a horizontal line in the coronal plane through the tracheoesophageal groove. Our objective was to determine the accuracy, validity, and inter-rater reliability of this method. Method This was a retrospective review of patients who underwent parathyroidectomy for a single adenoma between 2010-2017. SPECT/CT images were reviewed by two staff Otolaryngologists, a Radiologist, an Otolaryngology fellow and Otolaryngology resident. Results were compared using intra-operative report as the gold standard. Overall accuracy in determining superior/inferior and right/left adenomas was calculated, as well as Cohen's Kappa to determine agreement with operative report and inter-rater reliability. The performance was compared to that of the original radiology report. Results One hundred thirty patients met criteria and were included. Our method correctly identified the location of the adenoma in terms of both side and superior/inferior position in 80.4% [76 - 84%] of patients, which considerably outperformed the original radiology report at 48.5% [4-78%] accuracy. The agreement level between our method and operative report was high (Kappa=0.717 [0.691-0.743]), as was the inter-rater reliability (Kappa=0.706 [0.674-0.738]). Conclusion We report a novel method for localization of parathyroid adenomas using SPECT/CT which outperforms standard radiology reporting. This tool can be used by surgeons and radiologists to better inform and plan for minimally invasive parathyroidectomy.http://link.springer.com/article/10.1186/s40463-018-0307-6 |
| spellingShingle | Rachelle A. LeBlanc Andre Isaac Jonathan Abele Vincent L. Biron David W. J. Côté Matthew Hearn Daniel A. O’Connell Hadi Seikaly Jeffrey R. Harris Validation of a novel method for localization of parathyroid adenomas using SPECT/CT Journal of Otolaryngology - Head and Neck Surgery |
| title | Validation of a novel method for localization of parathyroid adenomas using SPECT/CT |
| title_full | Validation of a novel method for localization of parathyroid adenomas using SPECT/CT |
| title_fullStr | Validation of a novel method for localization of parathyroid adenomas using SPECT/CT |
| title_full_unstemmed | Validation of a novel method for localization of parathyroid adenomas using SPECT/CT |
| title_short | Validation of a novel method for localization of parathyroid adenomas using SPECT/CT |
| title_sort | validation of a novel method for localization of parathyroid adenomas using spect ct |
| url | http://link.springer.com/article/10.1186/s40463-018-0307-6 |
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