Parathyroid imaging: comparison of high-resolution CT and high-resolution sonography

Stark, D D; Gooding, Gretchen A. W.; Moss, AA; Clark, Orlo H.; Ovenfors, Carl-Olof

doi:10.2214/ajr.141.4.633

Cited by 70 publications

(15 citation statements)

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“…In cases where malignancy is suspected, higher-resolution anatomical studies are of considerable value [94]. Computed tomography (CT) with contrast will provide excellent details on the location of the lesion and its relation with other structures [95], and can also reveal invasion of surrounding structures and enlarged lymph nodes. Magnetic resonance imaging (MRI) with gadolinium and fat suppression will give the best detail on soft tissues of the neck, and can supplement further information, specifically in the setting of preoperative assessment.…”

Section: Work-upmentioning

confidence: 99%

Parathyroid Carcinoma

2010

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Parathyroid carcinoma is a rare endocrine malignancy. The reported incidence is from 0.5 to 5% of primary hyperparathyroidism cases in various series. The cause is unknown, but clinical correlations with different genetic syndromes exist. Mutations in the HPRT2 gene seem to play a significant role in the pathogenesis of this disease. Men and women are equally affected, usually in the fourth or fifth decade of life. Most patients will present with signs and symptoms of hypercalcaemia. Cases of non-functioning carcinoma are exceedingly rare. Surgical resection is the most effective method of treatment and palliation. A significant proportion of patients will experience recurrence, and will need further surgical and, eventually, medical management of hypercalcaemia. The disease is progressive but slow growing. Most patients will require multiple operations to resect recurrent disease. The main cause of morbidity and mortality is the sequela of uncontrolled chronic hypercalcaemia rather than tumour burden. The current paper will review the epidemiology, pathogenesis, clinical presentation and diagnostic work-up of this disease. Surgical management in different scenarios is reviewed in detail, followed by other types of treatment and management of incurable disease.

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Section: Work-upmentioning

confidence: 99%

Parathyroid Carcinoma

2010

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“…Most surgeons depend on technetium 99‐m nuclear scintigraphy 5 (sestamibi) for first‐line localization of PA, although PA can also be visualized with other modalities such as ultrasound (US), 6–8 single photon emission computed tomography (SPECT), 9 magnetic resonance imaging, and 4‐dimensional computed tomography (CT) 10 . Although not widely used for this indication, high‐resolution contrast‐enhanced CT is a widely available, rapid, and relatively low cost modality that can also be used to localize PA 1,11–13 …”

Section: Introductionmentioning

confidence: 99%

“…In addition, the acquisition of CT is highly reproducible, whereas US, and to a lesser degree nuclear scintigraphy, is highly operator dependent. Because of their highly vascular nature, PA can be visualized by contrast‐enhanced CT in many patients, 11–14 but experience with CT for this purpose is limited, or is limited to its use in fusion imaging with SPECT/CT. Currently, there are few reports in the literature documenting the reliability of CT for this purpose 10,12,13 …”

Section: Introductionmentioning

confidence: 99%

“…4 Most surgeons depend on technetium 99-m nuclear scintigraphy 5 (sestamibi) for first-line localization of PA, although PA can also be visualized with other modalities such as ultrasound (US), 6 -8 single photon emission computed tomography (SPECT), 9 magnetic resonance imaging, and 4-dimensional computed tomography (CT). 10 Although not widely used for this indication, high-resolution contrastenhanced CT is a widely available, rapid, and relatively low cost modality that can also be used to localize PA. 1,[11][12][13] Despite experience demonstrating the reliability of planar sestamibi and SPECT for first-line preoperative localization of PA, there are several disadvantages to these scintigraphic techniques. Although both planar sestamibi and SPECT provide functional information regarding the presence of a hyperactive parathyroid gland, and SPECT can provide three-dimensional imaging, the ability of these techniques to display precise anatomic detail is limited.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there are few reports in the literature documenting the reliability of CT for this purpose. 10,12,13 Our institutional preoperative algorithm for localization of PA 11 employs US for first-line imaging. 6,7 When US is indeterminate, second-line localization with sestamibi and CT is obtained.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Role of Computed Tomography for Localization of Parathyroid Adenomas

et al. 2008

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Parathyroid Aspiration Biopsy Under Ultrasonographic Guidance

Verbanck¹,

Clarysse²,

Loncke³

et al. 1986

Archives of Otolaryngology - Head and Neck Surgery

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\s=b\Localization of hyperfunctioning parathyroid glands is difficult. We examined 16 patients with biochemically proven primary or secondary hyperparathyroidism, using a 5-MHz 90\s=deg\real-time sector transducer. In those 16 patients, ultrasonographically guided fine-needle aspiration biopsy of 26 hypoechogenic retrothyroid nodules was performed. Hyperplastic parathyroid tissue was obtained from 24 retrothyroid nodules in 14 patients. In the other two patients, normal thyroid tissue was obtained. Both specificity and sensitivity of the aspiration biopsy technique were 100%. No complications occurred. We concluded that this technique is safe, simple, and very helpful in the localization of parathyroid tumors before surgery or before alcoholization.

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Parathyroid imaging: comparison of high-resolution CT and high-resolution sonography

Cited by 70 publications

References 0 publications

Parathyroid Carcinoma

Parathyroid Carcinoma

The Role of Computed Tomography for Localization of Parathyroid Adenomas

Parathyroid Aspiration Biopsy Under Ultrasonographic Guidance

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