Imaging in parathyroid diseases

Abstract

Preoperative imaging studies play an important role in providing successful localization of parathyroid lesions and their use has increased and -parallels the recent growth of minimally invasive parathyroidectomy. The development of simple, noninvasive imaging studies and the increasingly popular surgical technique known as minimally invasive parathyroidectomy have greatly expanded the role of preoperative localization procedures. A variety of anatomic and functional imaging techniques can be used to localize parathyroid lesions, including ultrasound, MRI -(magnetic resonance imaging), CT, and scintigraphy. The diagnostic imaging algorithms vary between institutions based on local availability and clinical expertise. Initial imaging usually includes ultrasonography and parathyroid scintigraphy. In the evaluation of hyperparathyroidism, tomographic SPECT imaging has been shown to have incremental value over planar scintigraphy for parathyroid lesion localization. MRI and contrast-enhanced CT are usually reserved for problem-solving when initial -imaging studies are negative, equivocal or contradictory.