European Journal of Nuclear Medicine and Molecular Imaging

, Volume 34, Issue 6, pp 926–933

Scintigraphic techniques in primary hyperparathyroidism: from pre-operative localisation to intra-operative imaging

  • Domenico Rubello
  • Milton D. Gross
  • Giuliano Mariani
  • Adil AL-Nahhas
Occasional survey

DOI: 10.1007/s00259-007-0388-3

Cite this article as:
Rubello, D., Gross, M.D., Mariani, G. et al. Eur J Nucl Med Mol Imaging (2007) 34: 926. doi:10.1007/s00259-007-0388-3



Primary hyperparathyroidism (PHPT) is an increasingly diagnosed disease worldwide. In most cases, PHPT is related to the presence of a solitary parathyroid adenoma (PA). Fifty percent or more of newly diagnosed PHPT patients are asymptomatic, and there is debate among endocrinologists and endocrine surgeons about whether or not such patients should be treated.


Usually, in a PHPT patient with a solitary PA that is well localised pre-operatively, a parathyroidectomy with limited or minimally invasive neck exploration is offered. The diffusion of minimally invasive neck exploration procedures is a consequence of the significant improvement in the accuracy of pre-operative imaging (mainly scintigraphic) techniques; these techniques have changed the surgical strategy to PHPT, from the wide traditional bilateral neck exploration to limited neck exploration.


The present review considers developments during the past 10–15 years with regard to both the accuracy of pre-operative localising imaging techniques and intra-operative minimally invasive procedures in order to provide endocrinologists and endocrine surgeons with further information about the newly available diagnostic and therapeutic tools for use in PHPT patients with a solitary PA.


Primary hyperparathyroidism99mTc-MIBIMinimally invasive parathyroidectomyRadio-guided surgeryGamma probe

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Domenico Rubello
    • 1
  • Milton D. Gross
    • 2
  • Giuliano Mariani
    • 3
  • Adil AL-Nahhas
    • 4
  1. 1.Service of Nuclear MedicineS. Maria della Misericordia HospitalRovigoItaly
  2. 2.Nuclear Medicine ServiceDepartment of Veterans Affairs Health SystemAnn ArborUSA
  3. 3.Regional Center of Nuclear MedicineUniversity of PisaPisaItaly
  4. 4.Department of Nuclear MedicineHammersmith HospitalLondonUK