Localization of Parathyroid Glands Preoperatively

  • Routine preoperative localization in patients with PHPT includes:
    • Neck ultrasound and technetium-99m– labeled sestamibi scan
  • Sestamibi scan:
    • Has a reported sensitivity as high as:
      • 90%
  • Ultrasound:
    • Is slightly less sensitive:
      • 75%
    • But the ease of in-office use:
      • Makes it a useful tool for the head and neck surgeon
  • SPECT:
    • When used with planar sestamibi:
      • Is very good at locating potential ectopic glands such as those in the mediastinum
  • 4D-CT:
    • Incorporates contrast perfusion:
      • In hyperfunctioning parathyroid tissue over time:
        • This additional layer provides functional information in addition to the anatomic information provided by a standard CT scan
    • In a recent study, 4D-CT has shown improved sensitivity over all other modalities:
      • Especially when used in combination with ultrasound

#Arrangoiz #ParathyroidSurgeon #ParathyroidExpert #Hypercalcemia #PHPT #Hyperparathyroidism #PrimaryHyperparathyroidism #EndocrineSurgery #HeadandNeckSurgeon #CancerSurgeon #Surgeon #Teacher #Miami #Mexico #MountSinaiMedicalCenter #MSMC

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