Effectiveness of using SPECT/CT to reduce operating room times in surgical parathyroid patients

Objectives With the advancement of SPECT/CT capabilities as a method of acquisition, images produced are able to provide functional information from SPECT along with anatomical information from CT. Patients with hyperparathyroidism imaged pre-surgically using Tc99m Sestamibi, can benefit from CT resulting in an increased efficiency of locating abnormal parathyroid glands. Increased efficiency can lead to fewer instances of surgical failure and a decrease in the amount of time spent operating on patients. The disadvantages of using SPECT/CT acquisition are increased costs, longer scanning times, and increased radiation exposure. The purpose of this study was to determine if the use of SPECT/CT, versus using SPECT only, is an effective way of locating abnormal parathyroid glands in regards to a decrease in the amount of time spent in the OR.

Methods A retrospective study of all patients who underwent a pre-surgical parathyroid scan between January 2011-October 2012 and October 2013-Dec 2014 were obtained and categorized into groups of individuals who received SPECT/CT (n=48) and those who received SPECT only (n=51). The amount of time each patient spent in surgery, from cut to close, was then obtained using electronic medical records and evaluated using a two-tailed t-test to look for a significant difference in mean surgical times between SPECT/CT and SPECT acquisitions.

Results The mean surgical times were 146.4 minutes using SPECT/CT acquisition and 132.7 minutes using SPECT acquisition (P=0.4). Although acquisition using only SPECT showed a lower mean surgical time, these values showed no evidence of a statistically significant difference between means (P>0.05).

Conclusions The use of SPECT/CT was not effective in locating parathyroid adenomas compared to the use of SPECT in regards to a decrease in the amount of time spent in surgery during parathyroidectomy procedures. However, even though there was no significant difference in the mean surgical times, SPECT/CT is still the preferred acquisition method for surgeons.