July-August 2016

Introduction

Dynamic Contrast-Enhanced CT and MR Imaging for Preoperative Localization of Parathyroid Lesions

Guest EditorHillary Kelly

Guest Editor Hillary R. Kelly

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 … more »

Head & Neck

4D-CT for Preoperative Localization of Abnormal Parathyroid Glands in Patients with Hyperparathyroidism: Accuracy and Ability to Stratify Patients by Unilateral versus Bilateral Disease in Surgery-Naïve and Re-Exploration Patients

George J. Hunter

George J. Hunter

Hyperparathyroidism became unequivocally recognized and accepted as the cause of the debilitating bone disease osteitis fibrosa cystica circa 1925. It was at that time that Edward Churchill and Oliver Cope successfully removed a mediastinal parathyroid adenoma at the Massachusetts General Hospital in Boston (MGH). Subsequently, parathyroid surgery slowly developed around the … more »

Head & Neck

Accuracy of 2-Phase Parathyroid CT for the Preoperative Localization of Parathyroid Adenomas in Primary Hyperparathyroidism

Brent Griffith

Brent Griffith

Primary hyperparathyroidism, a disorder caused by the presence of one or more hyperfunctioning parathyroid glands, is ideally treated by surgical removal of the hyperfunctional tissue. In the past, this required bilateral cervical exploration, but improvements in preoperative gland localization and intraoperative parathyroid hormone assays have led to increased use of minimally invasive, or … more »

Head & Neck

Dynamic 4D MRI for Characterization of Parathyroid Adenomas: Multiparametric Analysis

Kambiz Nael

Kambiz Nael

There has been a need for accurate preoperative localization of parathyroid adenomas (PTAs) to decrease size of surgical incisions and complication rates. While ultrasound and technetium Tc99m sestamibi scintigraphy have been used as first-line tools to localize PTA, these tests can often be inconclusive.

Therefore, 4D-CT has been established as an alternative cross-sectional imaging … more »

Head & Neck

Predictors of Multigland Disease in Primary Hyperparathyroidism: A Scoring System with 4D-CT Imaging and Biochemical Markers

Ali Sepahdari

Ali Sepahdari

Multiphasic multidetector parathyroid CT (“4D-CT”) is an increasingly popular tool for preoperative localization of abnormal parathyroid glands in patients with primary hyperparathyroidism. It is often used when other techniques fail, and is increasingly also being used as a first-line localization strategy.

The existing literature on 4D-CT has documented and validated its advantages over scintigraphy … more »

Head & Neck

Dynamic CT for Parathyroid Disease: Are Multiple Phases Necessary?

Prashant Raghavan

Prashant Raghavan

Primary hyperparathyroidism (HPT) is a fatal illness if left untreated. Surgical removal of the hyperfunctioning gland remains the only effective treatment available. Imaging plays a vital role in localizing one or more abnormal parathyroid glands for surgical planning. Traditionally, ultrasonography and technetium Tc99m sestamibi scintigraphy have been employed in localizing abnormal parathyroid glands. … more »