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World J Radiol. Sep 28, 2014; 6(9): 726-729
Published online Sep 28, 2014. doi: 10.4329/wjr.v6.i9.726
Low dose four-dimensional computerized tomography with volume rendering reconstruction for primary hyperparathyroidism: How I do it?
Timothy A Platz, Moshim Kukar, Rania Elmarzouky, William Cance, Ahmed Abdelhalim
Timothy A Platz, Moshim Kukar, William Cance, Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, United States
Rania Elmarzouky, Ahmed Abdelhalim, Department of Neuroradiology, Roswell Park Cancer Institute, Buffalo, NY 14263, United States
Author contributions: All authors contributed to this paper.
Correspondence to: Moshim Kukar, MD, Department of Surgical Oncology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States. moshim.kukar@roswellpark.org
Telephone: +1-716-8458972 Fax: +1-716-8453828
Received: May 9, 2014
Revised: June 25, 2014
Accepted: July 25, 2014
Published online: September 28, 2014
Abstract

Modification of 4-dimensional computed tomography (4D-CT) technique with volume rendering reconstructions and significant dose reduction is a safe and accurate method of pre-operative localization for primary hyperparathyroidism. Modified low dose 4D-CT with volume rendering reconstructions provides precise preoperative localization and is associated with a significant reduction in radiation exposure compared to classic preoperative localizing techniques. It should be considered the preoperative localization study of choice for primary hyperparathyroidism.

Keywords: Radiology, Nuclear medicine, Medical imaging

Core tip: To our knowledge, this is the first paper detailing the technical aspects of a low dose 4-dimensional computed tomography with volume rendering reconstruction. It is our aim to share our institute’s technique and experience in the hope of improved utilization of this modality. With this technique, our results are comparable to those published in the literature for diagnostic accuracy regarding correlation to intraoperative pathology. The 3D Volume rendering reconstruction of the parathyroid pathology shown in relation to the clavicle, thyroid gland, and skin provide superior surgical guidance and an essentially “cut here” approach for directed parathyroidectomy.