Optimal Use of Preoperative Imaging in Primary Hyperparathyroidism

To the Editor We read with interest the article titled “Factors Associated With Discordance Between Preoperative Parathyroid 4-Dimensional Computed Tomographic Scans and Intraoperative Findings During Parathyroidectomy” by Sho et al.¹ In this study, the authors reported a discordance rate of 29.9% using parathyroid 4-dimensional computed tomography (4D-CT) as the sole preoperative imaging modality in primary hyperparathyroidism (and a rate of 25% if surgeon-led ultrasonography [US] and 4D-CT were combined). In addition, they conducted a thorough analysis of putative factors contributing to this inaccuracy.