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Review Article   

Minerva Endocrinology 2022 Aug 01

DOI: 10.23736/S2724-6507.22.03833-7


language: English

Non-dynamic and multi-phase CT protocols for parathyroid glands imaging: a review of technical parameters, radiation dose and diagnostic accuracy

Christos P. DIMITROUKAS 1, 2, Vasileios I. METAXAS 1, Fotios O. EFTHYMIOU 1, Petros E. ZAMPAKIS 3, 4, George S. PANAYIOTAKIS 1 ,2 , Christina P. KALOGEROPOULOU 3, 4

1 Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece; 2 Department of Medical Physics, University Hospital of Patras, Patras, Greece; 3 Department of Radiology, School of Medicine, University of Patras, Patras, Greece; 4 Department of Radiology, University Hospital of Patras, Patras, Greece


Our purpose is to review the scientific literature and collect information regarding clinical and technical parameters of different single- or multi-phase CT protocols, their diagnostic performance and patient dose during parathyroid imaging. PubMed and Scopus databases were searched for studies investigating the diagnostic performance of CT in detecting parathyroid lesions and the corresponding patients' dose. The following information was retrieved for each article: CT system, number, combination and time interval between phases, scanning length, sensitivity, specificity, accuracy, positive and negative predictive values, contrast enhancement in Hounsfield Units (HUs), technical and exposure parameters, and dose indices. Fifty studies published during the last sixteen years (2005-2021) were reviewed. A large discrepancy in the number and combination of phases, as well as clinical and technical parameters of the CT protocols was indicated. The variations in patients' doses are mainly due to scanners' technology, number and combination of phases, the extent of scanning length, technical parameters (tube voltage, tube-current modulation, pitch, reconstruction algorithms), and patient-related parameters. Technical parameters are not always adjusted appropriately to the clinical question or patient size. These variations indicate a large potential to optimise dose during parathyroid imaging without compromising diagnostic performance. The potential is to decrease the number of phases or use low tube voltage protocols, tube-current modulation, iterative reconstruction, and reduce the scanning length during some phases. The reporting results could inform researchers about the current status of CT parathyroid imaging and guide their future efforts to optimise both patients' dose and corresponding image quality.

KEY WORDS: Computed Tomography; Parathyroid; Diagnostic accuracy; Radiation dose

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