Preoperative Localization of Parathyroid Adenomas Using 4-Dimensional Computed Tomography: A Pictorial Essay

• Published in: Canadian Association of Radiologists journal Vol. 64; no. 3; pp. 258 - 268
• Main Authors: Ellika, Shehanaz, MD, Patel, Suresh, MD, Aho, Todd, MD, Marin, Horia, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2013; SAGE PUBLICATIONS, INC
• Subjects: Adenoma; Adenoma - diagnostic imaging; Adenoma - surgery; Adult; Aged; Contrast Media; Endocrine system; Female; Four-Dimensional Computed Tomography - methods; Humans; Hyperplasia - diagnostic imaging; Hyperplasia - surgery; Male; Medical diagnosis; Middle Aged; Parathyroid Glands - diagnostic imaging; Parathyroid Glands - surgery; Parathyroid Neoplasms - diagnostic imaging; Parathyroid Neoplasms - surgery; Preoperative Care - methods; Radiographic Image Enhancement - methods; Radiology; Reproducibility of Results; Surgery; Tomography; Triiodobenzoic Acids
• ISSN: 0846-5371; 1488-2361
• DOI: 10.1016/j.carj.2012.03.002

Abstract Accurate preoperative localization is the key to successful parathyroid surgery in the era of minimally invasive parathyroid surgery. This article presents and discusses the embryologic basis of parathyroid gland and ectopic location and different imaging modalities helpful in diagnosing and localizing parathyroid adenomas and/or hyperplasia. We also aim to review the current surgical concepts in treatment of parathyroid adenomas and/or hyperplasia, the utility of 4-dimensional computed tomography for accurate preoperative localization of hyperfunctioning parathyroid glands, imaging classification of adenomas and/or hyperplasia, and, finally, present some of the limitations of 4-dimensional computed tomography.