Minimally invasive parathyroidectomy (MIP) has increasingly become the standard of care for surgical treatment of primary hyperparathyroidism over bilateral neck exploration, due decreased morbidity and costs, with similar rates of surgical cure.1–3 Precise and accurate preoperative localization is critical to the successful performance of MIP, and parathyroid imaging has gone through a series of changes and innovation as a result. Cross-sectional imaging has much to offer this patient population. In this issue of the AJNR News Digest, we highlight the emerging techniques of dynamic contrast-enhanced CT and MR imaging for preoperative localization of parathyroid lesions.
Multiphase multidetector CT for localization of parathyroid adenomas and multigland hyperplasia is also known as 4D-CT (4-dimensional CT), referring to the combination of multiplanar “3-dimensional CT” and the added fourth “dimension” derived from changes in enhancement over time.4 Although the vast majority of the literature has focused on 4D-CT4–11, a few recent studies have outlined a similar approach using MRI.12–14
4D-CT was first described in the surgical literature in 2006,4 … more »