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

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM Minerva endocrinology Pub Date : 2023-06-01 DOI:10.23736/S2724-6507.22.03833-7
Christos P Dimitroukas, Vasileios I Metaxas, Fotios O Efthymiou, Petros E Zampakis, George S Panayiotakis, Christina P Kalogeropoulou
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Abstract

Introduction: Our purpose was to review the scientific literature and collect information regarding clinical and technical parameters of different single- or multiphase CT protocols, their diagnostic performance and patient dose during parathyroid imaging.

Evidence acquisition: 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.

Evidence synthesis: 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 optimize 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.

Conclusions: The reporting results could inform researchers about the current status of CT parathyroid imaging and guide their future efforts to optimize both patients' dose and corresponding image quality.

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甲状旁腺成像的非动态和多相CT方案:技术参数,辐射剂量和诊断准确性的回顾。
简介:我们的目的是回顾科学文献,收集关于不同的单期或多期CT方案的临床和技术参数,它们的诊断性能和甲状旁腺成像患者剂量的信息。证据获取:检索PubMed和Scopus数据库,研究CT检测甲状旁腺病变的诊断性能及相应患者的剂量。检索每篇文章的以下信息:CT系统、数量、相间组合和时间间隔、扫描长度、灵敏度、特异性、准确性、阳性和阴性预测值、霍斯菲尔德单位(HUs)的对比增强、技术和暴露参数以及剂量指标。回顾了过去16年(2005-2021年)发表的50项研究。证据综合:CT方案的阶段数量和组合,临床和技术参数存在较大差异。患者剂量的变化主要是由于扫描仪的技术、相位的数目和组合、扫描长度的范围、技术参数(管电压、管电流调制、节距、重建算法)和患者相关参数。技术参数并不总是根据临床问题或患者大小适当调整。这些变化表明在甲状旁腺成像期间优化剂量而不影响诊断性能的潜力很大。潜在的方法是减少相位数或使用低管电压协议、管电流调制、迭代重建,并缩短某些相位的扫描长度。结论:本报告的结果可以为研究人员提供CT甲状旁腺成像的现状,并指导他们未来优化患者的剂量和相应的图像质量。
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146
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