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Parathyroid imaging

The diagnosis of hyperparathyroidism (HPT) is clinical. On the other hand, the detection and localization of hyperfunctioning parathyroids rely on imaging, most commonly radionuclide imaging techniques. Surgery of the affected gland(s), in symptomatic and to some extent asymptomatic patients, is the only curative therapy. Successful surgery requires an experienced surgeon and relies on the correct preoperative localization of all hyperfunctioning glands. Preoperative parathyroid imaging enables a more focused initial surgical approach, e.g. minimally invasive parathyroidectomy, with many advantages over bilateral open neck exploration, such as shorter duration of the surgery, reduced complications, improved cosmetic outcome, and decreased total hospital costs 1. Failure to correctly identify preoperatively the hyperfunctioning parathyroid gland(s) may lead to a more invasive surgical approach.

parathyroid scintigraphy, hyperparathyroidism, [99mTc]Tc-MIBI, SPECT/CT, [18F]FCH, [11C]CH, [11C]MET, PET/CT, cervical ultrasonography, 4D-CT, MRI

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