Radiology Research and Practice

Review Article

4DCT Scanning Technique for Primary Hyperparathyroidism: A Scoping Review

Table 1

Overview of the different protocols in the literature: number and timing of different phases, tube current/voltage, contrast volume and injection speed, effective dose, and sensitivity/specificity/PPV/NPV/accuracy.
ReferenceAuthorsYear publishedStudy designNECTTrackingContrast phase timingNumber of phasesArterial phaseVenous phaseDelayed phaseVery delayed phaseTube current (mA)Tube voltage (kV)Contrast volumeInjection speedEffective dose (mSv)Sensitivity/specificity/PPV/NPV/accuracy
[15]Vijayasarathi et al.2020Case seriesYesYesRelative325–30 s60–80 s——????? 
[16]Wojtczak et al.2020ReviewYesNoRelative425–30 s25–30 s85–90 s—????? 
[17]Acar et al.2020Retrospective studyYesNoAbsolute425 s40 s80 s—??0.1 mL/kg??Sensitivity 50%
Specificity 100%
PPV 100%
NPV 85%
Accuracy 86.9%
[18]Zafereo et al.2019ReviewYesNoRelative325–30 s55–60 s——????27–28 
YesNoRelative325–30 s—70 s—????27–28 
[19]Kedarisetty et al.2019Retrospective studyYesNoAbsolute325 s—85 s—??75 mL??Sensitivity 80%
Specificity 75%
PPV 92%
NPV 50%
Accuracy 79%
[20]Yeh et al.2019Retrospective studyYesNoRelative330 s60 s——??75 mL4 mL/s22Sensitivity 79%
Specificity 96%
PPV 90%
NPV 90%
[21]Amadou et al.2019Retrospective studyYesNoAbsolute3—45 s70 s—50–100120120 mL?10–27Sensitivity 75%
Specificity 40%
PPV 80%
NPV 33%
[22]Vu et al.2019Retrospective studyYesNoAbsolute425 s55 s85 s—220130120 mL4 mL/s17.9 
[23]Binks et al.2019Retrospective studyYesNoAbsolute325–30 s45–50 s——????7.99–28Sensitivity 85.7%
PPV 94.7%
[24]Cunha-Bezerra et al.2018Retrospective studyYesYesRelative418–25 s48–55 s?—120–2001202 mL/kg max 120 mL4-5 L/s? 
[25]Tian et al.2018Retrospective cohort studyYesYesRelative3Aorta: 150HU30 s later——??100 mL4 mL/s9.3Sensitivity 72.9%
Sensitivity 60% (persistent/recument disease)
Sensitivity 67.4% (multigland disease)
[26]Christakis et al.2017Retrospective studyYesNoAbsolute425 s??—??120 mL3 mL/s?Sensitivity 79%
Specificity 100%
PPV 100%
NPV 44%
Accuracy 82%
[27]Morón et al.2017Retrospective studyYesNoAbsolute225 s———150–600120100 mL4 mL/s?Sensitivity 80%
Specificity 97%
PPV 89%
Accuracy 92%
[28]Goroshi et al.2017Retrospective studyYesNoAbsolute420 s60 s90 s—140–22012060 mL4 mL/s18.9Left/right localization: Sensitivity 93% (hypercalcemic)
Quadrant localization: Sensitivity 90% (hypercalcemic)
[29]Taywade et al.2017Prospective studyYesNoAbsolute325 s—80 s—??75 mL4 mL/s11–13 
[30]Zeina et al.2017Prospective studyYesNoAbsolute425 s60 s90 s—400120120 mL4 mL/s?Accuracy 96%
[31]Sho et al.2016Prospective studyYesNoRelative325 s55 s——230120100–120 mL3-4 mL/s?Sensitivity: 79% (multigland disease)
Specificity: 63%(multigland disease)
PPV:58% (multigland disease)
[32]Fitzgerald et al.2017Retrospective studyYesNoAbsolute330 s—90 s—180–60012075 mL3 mL/s10.4–28 
[33]Rameau et al.2017Case seriesYesNoRelative325 s55 s——150–300120100–120 mL4 mL/s?Sensitivity 84.6%
PPV 91.7%
[34]Ramirez et al.2016Retrospective studyYesNoAbsolute425 s55 s85 s-??120 mL4 mL/s14Sensitivity 93%
PPV:96%
YesNoAbsolute225 s———??120 mL4 mL/s6.8Sensitivity 97%
PPV:94%
[35]Forghani et al.2016Retrospective studyYesNoAbsolute425 s55 s85 s—??100 mL3.5 mL/s2.4–4.1 
[36]Lee et al.2016Retrospective studyYesNoAbsolute430 s60 s90 s—140–24012090 mL5 mL/s10.9 
[37]Hinsin et al.2015Case seriesYesNoAbsolute430 s—80 s—??75 mL3 mL/s13.8Left/right localization: Sensitivity 84.2% (hypercalcemic)
Left/right localization: Specificity 81.8% (hypercalcemic)
Quadrant localization: Sensitivity 76.5% (hypercalcemic)
Quadrant localization: Specificity 91.59% (hypercalcemic)
[38]Bahl et al.2015Retrospective studyYesNoAbsolute325 s45 s70 s—100–70012075 mL4 mL/s28Sensitivity 85%
Sensitivity: 94% (single gland disease)
Sensitivity: 59% (multigland disease)
[39]Boury2015ReviewYesNoAbsolute3—45 s70 s—???3 mL/s? 
[40]Hoang et al.2015Phantom studyYesNoAbsolute325 s—80 s—100–50012075 mL4 mL/s28 
[41]Lundstroem et al.2016Retrospective studyYesNoAbsolute522 s52 s82 s122 s200120100 mL3.5 mL/s5.56–10.4Left/right localization: Sensitivity 84% (hypercalcemic)
Left/right localization: Specificity 76% (hypercalcemic)
Quadrant localization: Sensitivity 55% (hypercalcemic)
Quadrant localization: Specificity 50% (hypercalcemic)
[42]Seeliger et al.2015Prospective studyYesNoAbsolute425 s50 s80 s—250120120 mL2 mL/s?PPV 93%
[43]Cham et al.2015Retrospective studyYesNoRelative325–34 s55–64 s——230120100–120 mL?? 
[44]Day et al.2015Retrospective studyYesNoAbsolute430 s60 s90 s—100–750120100,L3 mL/s?Sensitivity 93%
PPV 80%
[45]Campbell et al.2015Retrospective studyYesNoAbsolute2—50 s——100–44012075–100 mL?5.2Left/right localization: Sensitivity 77% (hypercalcemic)
Left/right localization: Specificity 87% (hypercalcemic)
Quadrant localization: Sensitivity 58% (hypercalcemic)
Quadrant localization: Specificity 91% (hypercalcemic)
[46]Sepahdari et al.2015Retrospective studyYesNoAbsolute325 s55 s——230120100–120 mL3–4 mL/s?Sensitivity 77%
YesNoAbsolute325 s—80 s—230120100–120 mL3–4 mL/s?Sensitivity: 95% (single gland disease)
Sensitivity: 55% (multigland disease)
[47]Suh et al.2015Case seriesYesNoAbsolute430 s60 s90 s—140–24012090 mL??Sensitivity 92.1%
Specificity 95.6%
PPV 87.5%
NPV 97.3%
Accuracy 94.7%
[48]Ginsburg et al.2015Retrospective studyYesNoAbsolute425 s55 s85 s—200120120 m4 mL/s?Sensitivity 50%
PPV 100%
Accuracy 54.5%
[49]Raghavan et al.2014Retrospective studyYesNoAbsolute425 s50 s80 s—50–400120120 mL4 mL/s?Accuracy, sensitivity, and specificity for localization and lateralization of the arterial phase alone were comparable with the full complement of 4 phases
[50]Brown et al.2015Retrospective cohort studyYesNoAbsolute334 s68 s——??70 mL3 mL/s7.99 mSv (3 phases)Sensitivity 92%
10.88,Sv(4 phases)PPV 89%
[14]Hoang et al.2014Case seriesYesNoAbsolute325 s—80 s—100–40012075 mL4 mL/s? 
[51]Hunter et al.2014Retrospective studyYesNoRelative330 s60 s——180–300140100 mL4 mL/s?Sensitivity 94%
Specificity 98.3%
PPV 96.7%
NPV 97.1%
[52]Bahl et al.2014Retrospective studyNoNoAbsolute220 s70 s——100–400120100 mL4 mL/s? 
YesNoAbsolute325 s—80 s—100–70012075 mL4 mL/s? 
[53]Kely et al.2014Retrospective studyYesNoRelative430 s45 s90 s—180–300140100 mL4 mL/s28PPV 85.8%
Accuracy 77.9%
YesNoRelative330 s45 s——180–300140100 mL4 mL/s21PPV 89%
Accuracy 87.1%
[54]Sepahdari et al.2013Retrospective studyYesNoRelative325–34 s55–84 s——230120100–120 mL3–4 mL/s2.2 mSv/phasesInterobserver comparison
Sensitivity 73% vs 55%
Specificity 88% vs 100%
PPV 91% vs 100%
NPV 64% vs 52%
Accuracy 78% vs 70%
[55]Hunter et al.2012Retrospective studyYesNoRelative425 s70–73 s—130–133 s240140120 mL4 mL/s21 mSv (3 phases)Left/right localization: Accuracy 93.7%
27 mSv (4 phases)Quadrant localization: Accuracy 86.6%
[56]Mahajan et al.2012?YesNoAbsolute430 s60 s90 s—??80 mL?10.4 
[57]Gafton et al.2012Case seriesNoNoAbsolute225 s—80 s—?120120 mL3 mL/s? 
[58]Kutler et al.2011Retrospective studyYesNoAbsolute2—50 s——220–320120125 mL3 mL/s12.2 
[59]Eichhom-Wharry et al.2011Retrospective studyNoNo?218 sImmediately——??100 mL??Accuracy 73%
NoNo?222 s (>55y)Immediately——??100 mL??
[13]Starker et al.2011Retrospective studyYesNoAbsolute430 s60 s—120 s100–750120100 mL3 mL/s?Left/right localization: Sensitivity 93.9%
Left/right localization: PPV 93.5%
Quadrant localization: Sensitivity 85.7%
Quadrant localization: PPV 84.9%
[60]Beland et al.2011Retrospective studyYesNoAbsolute430 s60 s90 s—100–750120???Sensitivity 82%
Specificity 92%
[61]Lubitz et al.2010Retrospective studyYesNoRelative430 s60 s—105 s180–300140100 mL?10Left/right localization: Sensitivity 73%
Quadrant localization: Sensitivity 60%
[62]Mortenson et al.2008Retrospective studyYesNoRelative425 s55 s85 s—??120 mL4 mL/s?Sensitivity 88%
[63]Rodgers et al.2006Mixed prospective and retrospective studyYesNo?325 s?——220140120 mL3 mL/s?Sensitivity 88%
Quadrant localization: Sensitivity 70%