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Comparison of single photon emission CT (SPECT) with SPECT/CT imaging in preoperative localization of parathyroid adenomas: A cost‐effectiveness analysis
Author(s) -
Barber Brittany,
Moher Conrad,
Côté David,
Fung Elaine,
O'Connell Daniel,
Dziegielewski Peter,
Harris Jeffrey
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24379
Subject(s) - medicine , ultrasound , nuclear medicine , radiology , single photon emission computed tomography , primary hyperparathyroidism , parathyroid adenoma , hyperparathyroidism , emission computed tomography , technetium tc 99m sestamibi , parathyroid neoplasm , positron emission tomography , scintigraphy
Background Controversy exists regarding the superiority of single photon emission CT (SPECT)/CT over SPECT for preoperative localization of parathyroid adenomas in primary hyperparathyroidism (PHPT), as well as the cost‐effectiveness. Methods A retrospective review was undertaken of patients undergoing surgery for PHPT from January 2009 to August 2014. Ultrasound and SPECT (ultrasound‐SPECT) or SPECT/CT (ultrasound‐SPECT/CT) were performed for each patient. Sensitivity and positive predictive value (PPV) of each modality were calculated. Cost‐effectiveness was determined by an incremental cost‐effectiveness ratio (ICER) analysis. Results Two hundred fifty‐nine patients with 266 parathyroid adenomas were included in the study. Lateralization sensitivity and PPV of ultrasound‐SPECT were 85.1% and 98.2%, respectively. The lateralization sensitivity and PPV of ultrasound‐SPECT/CT were 86.9% and 99.4%, respectively. A cost of $2499.22 (CAD) per additional parathyroid adenoma detection by ultrasound‐SPECT/CT was determined from the ICER analysis. Conclusion Similar sensitivities and PPVs were observed between ultrasound‐SPECT and ultrasound‐SPECT/CT in preoperatively lateralizing parathyroid adenomas, with relatively equivalent cost‐effectiveness. © 2016 Wiley Periodicals, Inc. Head Neck 38 : E2062–E2065, 2016