Research

Suzannah Dewhurst1,2, Matthew Binks1,2, Andrew Thompson1,2, David Littlejohn2
1. University of New South Wales 
2. Wagga Wagga Base Hospital 

Aim

Knowing the anatomical location of parathyroid adenomas allows for minimally invasive  parathyroidectomy. A multidisciplinary team (MDT) has been set up in Wagga Wagga New South  Wales to improve services for regional and rural patients with parathyroid pathology. The objective  of this study is to determine the impact and efficacy of the MDT on surgical planning for these patients.

Method/Description

Patients included in the parathyroid MDT meetings in Wagga Wagga between June 2020 and  September 2021 were retrospectively reviewed. Data was collected on the imaging modality utilised,  the pre and post MDT meeting surgical plan, and surgical findings. A survey was sent to members of  the multidisciplinary team to determine their perception of its effectiveness.

Results

Forty-four patients with parathyroid adenoma were discussed throughout the sixteen-month time  frame. The MDT confirmed the initial surgical plan for forty-one per cent of patients, changed the  plan for eighteen per cent, and formed the initial management plan for twenty-one per cent of  cases. Twenty per cent of cases were discussed retrospectively to the time of operation. One  hundred percent of patients underwent a 4DCT. Eighteen per cent underwent dual ultrasound by  radiologist and surgeon, a 4DCT, and a sestimibi scan. Three 4DCT reports were addended secondary  to the MDT findings.

Consclusions

The MDT led to a changed outcome or formed an initial management plan for a significant number  of patients in a regional setting. The MDT allowed dedicated communication between surgeon and  radiologist, with improved imaging evaluation and perceived benefits for patients.

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