Parathyroid Scintigraphy: How Does It Fit In?

Sinha, Partha; Oates, M. Elizabeth

doi:10.1148/radiol.2019190304

Cited by 2 publications

(1 citation statement)

References 9 publications

(8 reference statements)

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“…Advantages of MIBI include widespread availability of imaging acquisition and reader expertise and may show ectopic and deep/posterior glands that may be missed by ultrasound. MIBI can be used in patients who are unable to receive iodinated CT contrast and undergo 4D-CT due to a contrast allergy or renal failure [38] and has a lower radiation dose than 4D-CT [39]. Disadvantages include patient inconvenience given long imaging acquisition and wait times between early and delayed timepoints, more expensive than ultrasound or 4D-CT [40], atypical washout patterns hindering interpretation, and false-positive accumulation in thyroid nodules [20].…”

Section: Sestamibi Scintigraphymentioning

confidence: 99%

Preoperative Localization for Primary Hyperparathyroidism: A Clinical Review

2021

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With increasing use of minimally invasive parathyroidectomy (PTx) over traditional bilateral neck exploration in patients with primary hyperparathyroidism (PHPT), accurate preoperative localization has become more important to enable a successful surgical outcome. Traditional imaging techniques such as ultrasound (US) and sestamibi scintigraphy (MIBI) and newer techniques such as parathyroid four-dimension computed tomography (4D-CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) are available for the clinician to detect the diseased gland(s) in the preoperative workup. Invasive parathyroid venous sampling may be useful in certain circumstances such as persistent or recurrent PHPT. We review the diagnostic performance of these imaging modalities in preoperative localization and discuss the advantages and weaknesses of these techniques. US and MIBI are established techniques commonly utilized as first-line modalities. 4D-CT has excellent diagnostic performance and is increasingly performed in first-line setting and as an adjunct to US and MIBI. PET and MRI are emerging adjunct modalities when localization has been equivocal or failed. Since no evidence-based guidelines are yet available for the optimal imaging strategy, clinicians should be familiar with the range and advancement of these techniques. Choice of imaging modality should be individualized to the patient with consideration for efficacy, expertise, and availability of such techniques in clinical practice.

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