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Free Content Finding a Needle in a Haystack: Review of Imaging to Identify Parathyroid Adenoma

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Abstract:

Primary hyperparathyroidism is characterized by hypercalcemia secondary to increased production or altered excretion of the PTH. Primary hyperparathyroidism is the most common cause of primary hypercalcemia. This is typically caused by parathyroid adenomas. A parathyroid adenoma can be difficult to localize given its small size and occasional ectopic location. With the advent of newer imaging techniques and the intraoperative PTH assay, directed minimally invasive surgery has replaced the standard 4-gland exploration for resection of single-gland adenomas. For minimally invasive surgery, precise preoperative localization of the adenoma is critical. We aim to review the anatomy, embryology, and different imaging modalities helpful in diagnosing parathyroid adenomas, with particular emphasis on efficacy and limitation.

Keywords: 11C = carbon 11; PET = positron-emission tomography; PTH = parathyroid hormone; SPECT = single-photon emission CT; T1‐201= thallium 201; Tc-99m sestamibi = technetium-99m sestamibi

Document Type: Research Article

DOI: http://dx.doi.org/10.3174/ng.3110015

Publication date: December 1, 2011

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  • Neurographics is the peer-reviewed, quarterly educational journal of the American Society of Neuroradiology. The journal comprises mainly articles created from select scientific exhibits at the ASNR Annual Meeting. Neurographics will also publish other high-quality submissions that are primarily educational and have a high emphasis on a pictorial approach. Articles are available free online, and a print-on-demand edition can be ordered from the Neurographics site.

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