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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Parathyroid adenoma (PT Ad)
Definitions
- Benign neoplasm of parathyroid gland producing excess parathyroid hormone (PTH), resulting in hypercalcemia
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Acar N et al: Diagnostic value of four-dimensional computed tomography and four-dimensional magnetic resonance imaging in primary hyperparathyroidism when first-line imaging was inadequate. Ann R Coll Surg Engl. 102(4):294-9, 2020
- Bunch PM et al: Parathyroid 4D CT: what the surgeon wants to know. Radiographics. 40(5):1383-94, 2020
- Eller M et al: Accuracy of 4-dimensional computed tomography for localization in primary hyperparathyroidism. J Surg Res. 257:15-21, 2020
- Woisetschläger M et al: Dual energy 4D-CT of parathyroid adenomas not clearly localized by sestamibi scintigraphy and ultrasonography - a retrospective study. Eur J Radiol. 124:108821, 2020
- Yeh R et al: A simple formula to estimate parathyroid weight on 4D-CT, predict pathologic weight, and diagnose parathyroid adenoma in patients with primary hyperparathyroidism. AJNR Am J Neuroradiol. 41(9):1690-7, 2020
- Batchala PP et al: Retropharyngeal ectopic parathyroid adenoma versus lymph node: problem solving with CT neck angiogram. J Postgrad Med. 65(4):237-40, 2019
- Kluijfhout WP et al: Diagnostic performance of computed tomography for parathyroid adenoma localization; a systematic review and meta-analysis. Eur J Radiol. 88:117-28, 2017
- Nafisi Moghadam R et al: Comparative diagnostic performance of ultrasonography and 99mTc-sestamibi scintigraphy for parathyroid adenoma in primary hyperparathyroidism; systematic review and meta-analysis Asian Pac J Cancer Prev. 18(12):3195-200, 2017
- Bahl M et al: Parathyroid adenomas and hyperplasia on four-dimensional CT scans: three patterns of enhancement relative to the thyroid gland justify a three-phase protocol. Radiology. 277(2):454-62, 2015
- Michaud L et al: A pilot comparison of 18F-fluorocholine PET/CT, ultrasonography and 123I/99mTc-sestaMIBI dual-phase dual-isotope scintigraphy in the preoperative localization of hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism: influence of thyroid anomalies. Medicine (Baltimore). 94(41):e1701, 2015
- Bahl M et al: Prevalence of the polar vessel sign in parathyroid adenomas on the arterial phase of 4D CT. AJNR Am J Neuroradiol. 35(3):578-81, 2014
- Raghavan P et al: Dynamic CT for parathyroid disease: are multiple phases necessary? AJNR Am J Neuroradiol. 35(10):1959-64, 2014
- Aliyev A et al: Ectopic parathyroid adenoma localized with MIBI scintigraphy and excised with guide of macroaggregated human serum albumin injection. Clin Nucl Med. 35(3):151-3, 2010
- Patel CN et al: Clinical utility of ultrasound and 99mTc sestamibi SPECT/CT for preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism. Clin Radiol. 65(4):278-87, 2010
- Harari A et al: Negative preoperative localization leads to greater resource use in the era of minimally invasive parathyroidectomy. Am J Surg. 197(6):769-73, 2009
- Levine DS et al: Hybrid SPECT/CT imaging for primary hyperparathyroidism: case reports and pictorial review. Clin Nucl Med. 34(11):779-84, 2009
- Prommegger R et al: Virtual neck exploration: a new method for localizing abnormal parathyroid glands. Ann Surg. 250(5):761-5, 2009
- Randall GJ et al: Contrast-enhanced MDCT characteristics of parathyroid adenomas. AJR Am J Roentgenol. 193(2):W139-43, 2009
- Thomas DL et al: Single photon emission computed tomography (SPECT) should be routinely performed for the detection of parathyroid abnormalities utilizing technetium-99m sestamibi parathyroid scintigraphy. Clin Nucl Med. 34(10):651-5, 2009
- Usmani S et al: Minimally invasive radionuclide-guided parathyroidectomy using 99mTc-sestamibi in patients with primary hyperparathyroidism: a single-institution experience. Med Princ Pract. 18(5):373-7, 2009
- Harari A et al: Computed tomography can guide focused exploration in select patients with primary hyperparathyroidism and negative sestamibi scanning. Surgery. 144(6):970-6; discussion 976-9, 2008
- Parker EE et al: MR imaging of the thoracic inlet. Magn Reson Imaging Clin N Am. 16(2):341-53, x, 2008
- Rodgers SE et al: Primary hyperparathyroidism. Curr Opin Oncol. 20(1):52-8, 2008
- Zald PB et al: The role of computed tomography for localization of parathyroid adenomas. Laryngoscope. 118(8):1405-10, 2008
- Mazzeo S et al: Multidetector CT in diagnostic work-up of patients with primary hyperparathyroidism. Radiol Med. 112(5):763-75, 2007
- Rodgers SE et al: Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography. Surgery. 140(6):932-40; discussion 940-1, 2006
- Bentrem DJ et al: Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid. 12(12):1109-12, 2002
- van Dalen A et al: Minimally invasive surgery for solitary parathyroid adenomas in patients with primary hyperparathyroidism: role of US with supplemental CT. Radiology. 220(3):631-9, 2001
- Weber AL et al: The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am. 38(5):1105-29, 2000
- Purcell GP et al: Parathyroid localization with high-resolution ultrasound and technetium Tc 99m sestamibi. Arch Surg. 134(8):824-8; discussion 828-30, 1999
- Ishibashi M et al: Comparison of technetium-99m-MIBI, technetium-99m-tetrofosmin, ultrasound and MRI for localization of abnormal parathyroid glands. J Nucl Med. 39(2):320-4, 1998
- Norman J et al: Minimally invasive radioguided parathyroidectomy in the reoperative neck. Surgery. 124(6):1088-92; discussion 1092-3, 1998
- Ishibashi M et al: Localization of ectopic parathyroid glands using technetium-99m sestamibi imaging: comparison with magnetic resonance and computed tomographic imaging. Eur J Nucl Med. 24(2):197-201, 1997
- Neumann DR et al: Comparison of double-phase 99mTc-sestamibi with 123I-99mTc-sestamibi subtraction SPECT in hyperparathyroidism. AJR Am J Roentgenol. 169(6):1671-4, 1997
- Gordon BM et al: Parathyroid imaging with 99m Tc-sestamibi. AJR Am J Roentgenol. 167(6):1563-8, 1996
- Lee VS et al: The complementary roles of fast spin-echo MR imaging and double-phase 99m Tc-sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands. AJR Am J Roentgenol. 167(6):1555-62, 1996
- Vojvodich SM et al: Imaging and surgery in hyperparathyroidism: a 10-year review. J Otolaryngol. 25(2):126-9, 1996
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References
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Parathyroid adenoma (PT Ad)
Definitions
- Benign neoplasm of parathyroid gland producing excess parathyroid hormone (PTH), resulting in hypercalcemia
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Acar N et al: Diagnostic value of four-dimensional computed tomography and four-dimensional magnetic resonance imaging in primary hyperparathyroidism when first-line imaging was inadequate. Ann R Coll Surg Engl. 102(4):294-9, 2020
- Bunch PM et al: Parathyroid 4D CT: what the surgeon wants to know. Radiographics. 40(5):1383-94, 2020
- Eller M et al: Accuracy of 4-dimensional computed tomography for localization in primary hyperparathyroidism. J Surg Res. 257:15-21, 2020
- Woisetschläger M et al: Dual energy 4D-CT of parathyroid adenomas not clearly localized by sestamibi scintigraphy and ultrasonography - a retrospective study. Eur J Radiol. 124:108821, 2020
- Yeh R et al: A simple formula to estimate parathyroid weight on 4D-CT, predict pathologic weight, and diagnose parathyroid adenoma in patients with primary hyperparathyroidism. AJNR Am J Neuroradiol. 41(9):1690-7, 2020
- Batchala PP et al: Retropharyngeal ectopic parathyroid adenoma versus lymph node: problem solving with CT neck angiogram. J Postgrad Med. 65(4):237-40, 2019
- Kluijfhout WP et al: Diagnostic performance of computed tomography for parathyroid adenoma localization; a systematic review and meta-analysis. Eur J Radiol. 88:117-28, 2017
- Nafisi Moghadam R et al: Comparative diagnostic performance of ultrasonography and 99mTc-sestamibi scintigraphy for parathyroid adenoma in primary hyperparathyroidism; systematic review and meta-analysis Asian Pac J Cancer Prev. 18(12):3195-200, 2017
- Bahl M et al: Parathyroid adenomas and hyperplasia on four-dimensional CT scans: three patterns of enhancement relative to the thyroid gland justify a three-phase protocol. Radiology. 277(2):454-62, 2015
- Michaud L et al: A pilot comparison of 18F-fluorocholine PET/CT, ultrasonography and 123I/99mTc-sestaMIBI dual-phase dual-isotope scintigraphy in the preoperative localization of hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism: influence of thyroid anomalies. Medicine (Baltimore). 94(41):e1701, 2015
- Bahl M et al: Prevalence of the polar vessel sign in parathyroid adenomas on the arterial phase of 4D CT. AJNR Am J Neuroradiol. 35(3):578-81, 2014
- Raghavan P et al: Dynamic CT for parathyroid disease: are multiple phases necessary? AJNR Am J Neuroradiol. 35(10):1959-64, 2014
- Aliyev A et al: Ectopic parathyroid adenoma localized with MIBI scintigraphy and excised with guide of macroaggregated human serum albumin injection. Clin Nucl Med. 35(3):151-3, 2010
- Patel CN et al: Clinical utility of ultrasound and 99mTc sestamibi SPECT/CT for preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism. Clin Radiol. 65(4):278-87, 2010
- Harari A et al: Negative preoperative localization leads to greater resource use in the era of minimally invasive parathyroidectomy. Am J Surg. 197(6):769-73, 2009
- Levine DS et al: Hybrid SPECT/CT imaging for primary hyperparathyroidism: case reports and pictorial review. Clin Nucl Med. 34(11):779-84, 2009
- Prommegger R et al: Virtual neck exploration: a new method for localizing abnormal parathyroid glands. Ann Surg. 250(5):761-5, 2009
- Randall GJ et al: Contrast-enhanced MDCT characteristics of parathyroid adenomas. AJR Am J Roentgenol. 193(2):W139-43, 2009
- Thomas DL et al: Single photon emission computed tomography (SPECT) should be routinely performed for the detection of parathyroid abnormalities utilizing technetium-99m sestamibi parathyroid scintigraphy. Clin Nucl Med. 34(10):651-5, 2009
- Usmani S et al: Minimally invasive radionuclide-guided parathyroidectomy using 99mTc-sestamibi in patients with primary hyperparathyroidism: a single-institution experience. Med Princ Pract. 18(5):373-7, 2009
- Harari A et al: Computed tomography can guide focused exploration in select patients with primary hyperparathyroidism and negative sestamibi scanning. Surgery. 144(6):970-6; discussion 976-9, 2008
- Parker EE et al: MR imaging of the thoracic inlet. Magn Reson Imaging Clin N Am. 16(2):341-53, x, 2008
- Rodgers SE et al: Primary hyperparathyroidism. Curr Opin Oncol. 20(1):52-8, 2008
- Zald PB et al: The role of computed tomography for localization of parathyroid adenomas. Laryngoscope. 118(8):1405-10, 2008
- Mazzeo S et al: Multidetector CT in diagnostic work-up of patients with primary hyperparathyroidism. Radiol Med. 112(5):763-75, 2007
- Rodgers SE et al: Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography. Surgery. 140(6):932-40; discussion 940-1, 2006
- Bentrem DJ et al: Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid. 12(12):1109-12, 2002
- van Dalen A et al: Minimally invasive surgery for solitary parathyroid adenomas in patients with primary hyperparathyroidism: role of US with supplemental CT. Radiology. 220(3):631-9, 2001
- Weber AL et al: The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am. 38(5):1105-29, 2000
- Purcell GP et al: Parathyroid localization with high-resolution ultrasound and technetium Tc 99m sestamibi. Arch Surg. 134(8):824-8; discussion 828-30, 1999
- Ishibashi M et al: Comparison of technetium-99m-MIBI, technetium-99m-tetrofosmin, ultrasound and MRI for localization of abnormal parathyroid glands. J Nucl Med. 39(2):320-4, 1998
- Norman J et al: Minimally invasive radioguided parathyroidectomy in the reoperative neck. Surgery. 124(6):1088-92; discussion 1092-3, 1998
- Ishibashi M et al: Localization of ectopic parathyroid glands using technetium-99m sestamibi imaging: comparison with magnetic resonance and computed tomographic imaging. Eur J Nucl Med. 24(2):197-201, 1997
- Neumann DR et al: Comparison of double-phase 99mTc-sestamibi with 123I-99mTc-sestamibi subtraction SPECT in hyperparathyroidism. AJR Am J Roentgenol. 169(6):1671-4, 1997
- Gordon BM et al: Parathyroid imaging with 99m Tc-sestamibi. AJR Am J Roentgenol. 167(6):1563-8, 1996
- Lee VS et al: The complementary roles of fast spin-echo MR imaging and double-phase 99m Tc-sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands. AJR Am J Roentgenol. 167(6):1555-62, 1996
- Vojvodich SM et al: Imaging and surgery in hyperparathyroidism: a 10-year review. J Otolaryngol. 25(2):126-9, 1996
