Imaging and Imaging-Guided Intervention of the Parathyroid Glands

  • Georg M. Bongartz
  • Augustinus L. Jacob
  • Sebastian Kos
  • Egbert U. Nitzsche
  • Mehmet Ö. Öksüz


Primary hyperparathyroidism (HPTH) is often diagnosed accidentally as asymptomatic disease, when hypercalcemia and elevated PTH level are observed based upon a laboratory test. However, if a more vigorous patient’s history is taken, non-specific symptoms such as tiredness and irritation are frequently observed. In the majority of patients presenting with HPTH, cortical bone density is reduced, especially if measured at the distal radius. In about 80% of patients, a benign solitary parathyroid adenoma (PA) represents the cause of disease. Fourteen percent of patients present with multiple adenomas, in 5% hereditary forms of HPTH appear causative. In about 1% of cases, a parathyroid carcinoma is finally diagnosed.

Today, surgical therapy is recommended for all symptomatic patients with HPTH. Moreover, it must be emphasized that the results of several studies indicate that surgery may subsequently improve cortical bone density and the quality of life in such patients even in cases with mild HPTH [1]. Regarding surgery, minimal invasive parathyroidectomy represents the therapy of choice in the majority of patients.


Thyroid Nodule Parathyroid Gland Superior Vena Cava Parathyroid Adenoma Parathyroid Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Bilezikian JP, Khan AA, Potts JT Jr (2009) Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop. J Clin Endocrinol Metab 92:335–339CrossRefGoogle Scholar
  2. 2.
    Hindié E, Ugur Ö, Fuster D, O’Doherty M, Grassetto G, Ureña P, Kettle A, Gulec SA, Pons F, Rubello D (2009) 2009 EANM parathyroid guidelines. Eur J Nucl Med Mol Imaging 36:1201–1216PubMedCrossRefGoogle Scholar
  3. 3.
    Fuster D, Ybarra J, Ortiz J, Torregrosa JV, Gilabert R, Setoain X, Paredes P, Duch J, Pons F (2006) Role of preoperative imaging using 99mTc-MIBI and neck ultrasound in secondary hyperparathyroidism patients candidate for subtotal parathyroidectomy. Eur J Nucl Med Mol Imaging 33:467–473PubMedCrossRefGoogle Scholar
  4. 4.
    Lorberboym M, Minski I, Macadziob S, Nicolov G, Schachter P (2003) Incremental diagnostic value of preoperative 99mTc-MIBI SPECT in patients with a parathyroid adenoma. J Nucl Med 44:904–908PubMedGoogle Scholar
  5. 5.
    Billotey C, Sarfati E, Aurengo A, Duet M, Mündler O, Toubert ME, Rain JD, Najean Y (1996) Advantages of SPECT in technetium-99m-sestamibi parathyroid scintigraphy. J Nucl Med 37:1773–1778PubMedGoogle Scholar
  6. 6.
    Krausz Y, Israel O (2006) Single-photon emission computed tomography/computed tomography in endocrinology. Semin Nucl Med 36:267–274PubMedCrossRefGoogle Scholar
  7. 7.
    Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel BA, Townsend DW, Berland LL, Parker JA, Zubal G, Cronin V (2006) Procedure guideline for SPECT/CT imaging 1.0. J Nucl Med 47:1227–1234PubMedGoogle Scholar
  8. 8.
    Prommegger R, Wimmer G, Profanter C, Sauper T, Sieb M, Kovacs P, Bale R, Putzer D, Gabriel M, Margreiter R (2009) Virtual neck exploration: a new method for localizing abnormal parathyroid glands. Ann Surg 250:761–765PubMedCrossRefGoogle Scholar
  9. 9.
    Coakley AJ, Kettle AG, Wells CP, O’Doherty MJ, Collins RE (1989) 99Tcm sestamibi – a new agent for parathyroid imaging. Nucl Med Commun 10:791–794PubMedCrossRefGoogle Scholar
  10. 10.
    O’Doherty MJ, Kettle AG, Wells PC, Collins REC, Coakley AJ (1992) Parathyroid imaging with technetium-99m-sestamibi: preoperative localization and tissue uptake studies. J Nucl Med 33:313–318PubMedGoogle Scholar
  11. 11.
    Sundin A, Johansson C, Hellman P et al (1996) PET and parathyroid L-[carbon-11] methionineaccumulation in hyperparathyroidism. J Nucl Med 37:1766–1770PubMedGoogle Scholar
  12. 12.
    Beggs AD, Hain SF (2005) Localization of parathyroid ­adenomas using 11C-methionine positron emission tomography. Nucl Med Commun 26:133–136PubMedCrossRefGoogle Scholar
  13. 13.
    Herrmann K, Takei T, Kanegae K, Shiga T, Buck AK, Altomonte J, Schwaiger M, Schuster T, Nishijima K, Kuge Y, Tamaki N (2009) Clinical value and limitations of [11C]-methionine PET for detection and localization of suspected parathyroid adenomas. Mol Imaging Biol 11:356–363PubMedCrossRefGoogle Scholar
  14. 14.
    Classe JM, Fiche M, Rousseau C, Sagan C, Dravet F, Pioud R, Lisbona A, Ferrer L, Campion L, Resche I, Curtet C (2005) Prospective comparison of 3 gamma probes for sentinel lymph node detection in 200 breast cancer patients. J Nucl Med 46:395–399PubMedGoogle Scholar
  15. 15.
    Rubello D, Piotto A, Casara D, Muzzio PC, Shapiro B, Pelizzo MR (2003) Role of gamma probes in performing minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: optimization of preoperative and intraoperative procedures. Eur J Endocrinol 149:7–15PubMedCrossRefGoogle Scholar
  16. 16.
    Gough J, Anliker M, Spieth ME, Kasner DL (2004) Parathyroid adenoma radiation dose simulator. Clin Med Res 2:55–58PubMedCrossRefGoogle Scholar
  17. 17.
    Huppert BJ, Reading CC (2005) The parathyroid glands. In: Rumack CM, Wilson SR, Charboneau JW (eds) Diagnostic ultrasound. Elsevier-Mosby, St. Louis, pp 771–794Google Scholar
  18. 18.
    Gritzmann N, Koischwitz D, Rettenbacher T (2000) Sonography of the thyroid and parathyroid glands. Radiol Clin North Am 38:1131PubMedCrossRefGoogle Scholar
  19. 19.
    Scheible W, Deutsch AL, Leopold GR (1981) Parathyroid adenoma: accuracy of preoperative localization by high-resolution real-time sonography. J Clin Ultrasound 9:325PubMedCrossRefGoogle Scholar
  20. 20.
    Ghaheri BA, Koslin DB, Wood AH et al (2004) Preoperative ultrasound is worthwhile for reoperative parathyroid surgery. Laryngoscope 114:2168PubMedCrossRefGoogle Scholar
  21. 21.
    Giron J, Ouhayoun E, Dahan M, Berjaud J, Esquerre JP, Senac JP, Railhac JJ (1996) Imaging of hyperparathyroidism: US, CT, MRI and MIBI scintigraphy. Eur J Radiol 21(3):167–173PubMedCrossRefGoogle Scholar
  22. 22.
    Abboud B, Sleilaty G, Rabaa L, Daher R, Abou Zeid H, Jabbour H, Hachem K, Smayra T (2008) Ultrasonography: highly accuracy technique for preoperative localization of parathyroid adenoma. Laryngoscope 118(9):1574–1578PubMedCrossRefGoogle Scholar
  23. 23.
    Johnson NA, Yip L, Tublin ME (2010) Cystic parathyroid adenoma: sonographic features and correlation with 99mTc-sestamibi SPECT findings. AJR Am J Roentgenol 195(6):1385–1390PubMedCrossRefGoogle Scholar
  24. 24.
    Graif M, Itzchak Y, Strauss S et al (1987) Parathyroid sonography: diagnostic accuracy related to shape, location and texture of the gland. Br J Radiol 60:439PubMedCrossRefGoogle Scholar
  25. 25.
    Randel SB, Gooding GAW, Clark OH et al (1987) Parathyroid variants: ultrasound evaluation. Radiology 165:191PubMedGoogle Scholar
  26. 26.
    Obara T, Fujimoto Y, Ito Y (1989) Functioning parathyroid lipoadenoma-report of four cases: clinicopathological and ultrasonographic features. Endocrinol Jpn 36:135PubMedCrossRefGoogle Scholar
  27. 27.
    Lane MJ, Desser TS, Weigel RJ, Jeffrey RB Jr (1998) Use of colour and power Doppler sonography to identify feeding arteries associated with parathyroid adenomas. AJR Am J Roentgenol 171(3):819–823PubMedGoogle Scholar
  28. 28.
    Scheiner JD, Dupuy DE, Monchik JM, Noto RB, Cronan JJ (2001) Pre-operative localization of parathyroid adenomas: a comparison of power and colour Doppler ultrasonography with nuclear medicine scintigraphy. Clin Radiol 56(12):984–988PubMedCrossRefGoogle Scholar
  29. 29.
    Baskin HJ (2004) New applications of thyroid and parathyroid ultrasound. Minerva Endocrinol 29(4):195–206PubMedGoogle Scholar
  30. 30.
    Wolf RJ, Cronan JJ, Monchik JM (1994) Colour Doppler sonography: an adjunctive technique in assessment of parathyroid adenomas. J Ultrasound Med 13(4):303–308PubMedGoogle Scholar
  31. 31.
    Lee NC, Norton JA (2002) Multiple-gland disease in primary hyperparathyroidism: a function of operative approach? Arch Surg 137:896–899; discussion 899–900PubMedCrossRefGoogle Scholar
  32. 32.
    Russell CF, Grant CS, van Heerden JA (1982) Hyperfunctioning supernumerary parathyroid glands. An occasional cause of hyperparathyroidism. Mayo Clin Proc 57(2):121–124PubMedGoogle Scholar
  33. 33.
    Edis AJ, Purnell DC, Van Heerden JA (1979) The undescended “parathymus”. An occasional cause of failed neck exploration for hyperparathyroidism. Ann Surg 190:64–68PubMedCrossRefGoogle Scholar
  34. 34.
    Mansberger AR, Wei JP (1993) Surgical embryology and anatomy of the thyroid and parathyroid glands. Surg Clin North Am 73:727–746PubMedGoogle Scholar
  35. 35.
    Akerstrom G, Malmaeus J, Bergstrom R (1984) Surgical anatomy of human parathyroid glands. Surgery 95:14–21PubMedGoogle Scholar
  36. 36.
    Wang CA (1976) The anatomic basis of parathyroid surgery. Ann Surg 183:271–275PubMedCrossRefGoogle Scholar
  37. 37.
    Mariani G, Gulec SA, Rubello D et al (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44:1443–1458PubMedGoogle Scholar
  38. 38.
    Nudelman IL, Deutsch AA, Reiss R (1987) Primary hyperparathyroidism due to mediastinal parathyroid adenoma. Int Surg 72:104–108PubMedGoogle Scholar
  39. 39.
    Casara D, Rubello D, Cauzzo C et al (2002) Tc-99m MIBI radio-guided minimally invasive parathyroidectomy: experience with patients with normal thyroids and nodular goiters. Thyroid 12:53–61PubMedCrossRefGoogle Scholar
  40. 40.
    Wang CA (1977) Parathyroid re-exploration: a clinical and pathological study of 112 cases. Ann Surg 186:140–145PubMedCrossRefGoogle Scholar
  41. 41.
    Fakhran S, Branstetter BF IV, Pryma DA (2008) Parathyroid imaging. Neuroimaging Clin N Am 18:537–549PubMedCrossRefGoogle Scholar
  42. 42.
    Reeder SB, Desser TS, Weigel RJ, Jeffrey RB (2002) Sonography in primary hyperparathyroidism: review with emphasis on scanning technique. J Ultrasound Med 21:539–552PubMedGoogle Scholar
  43. 43.
    Huppert BJ, Reading CC (2007) Parathyroid sonography: imaging and intervention. J Clin Ultrasound 35:144–155PubMedCrossRefGoogle Scholar
  44. 44.
    Johnson NA, Tublin ME, Ogilvie JB (2007) Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. AJR Am J Roentgenol 188(6):1706–1715PubMedCrossRefGoogle Scholar
  45. 45.
    Khati N, Adamson T, Johnson KS, Hill MC (2003) Ultrasound of the thyroid and parathyroid glands. Ultrasound Q 19(4):162–176PubMedCrossRefGoogle Scholar
  46. 46.
    Feliciano DV (1992) Parathyroid pathology in an intrathyroidal position. Am J Surg 164:496–500PubMedCrossRefGoogle Scholar
  47. 47.
    Wang CA (1981) Hyperfunctioning intrathyroid parathyroid gland: a potential cause of failure in parathyroid surgery. J R Soc Med 74:49–52PubMedGoogle Scholar
  48. 48.
    Thompson NW, Eckhauser FE, Harness JK (1982) The anatomy of primary hyperparathyroidism. Surgery 92:814–821PubMedGoogle Scholar
  49. 49.
    Kaplan EL, Yashiro T, Salti G (1992) Primary hyperparathyroidism in the 1990s. Choice of surgical procedures for this disease. Ann Surg 215:300–317PubMedCrossRefGoogle Scholar
  50. 50.
    Prasad B, Fleming RM (2005) Intrathyroidal parathyroid adenoma. Clin Nucl Med 30:467–469PubMedCrossRefGoogle Scholar
  51. 51.
    Levin KE, Clark OH (1989) The reasons for failure in parathyroid operations. Arch Surg 124:911–914PubMedCrossRefGoogle Scholar
  52. 52.
    Cheung PSY, Borgstrom A, Thompson NW (1989) Strategy in re-operative surgery for hyperparathyroidism. Arch Surg 124:676–680PubMedCrossRefGoogle Scholar
  53. 53.
    Palmer JA, Rosen IB (1982) Re-operative surgery for hyperparathyroidism. Am J Surg 144:406–410PubMedCrossRefGoogle Scholar
  54. 54.
    Prinz RA, Gamvros OI, Allison DJ et al (1981) Re-operations for hyperparathyroidism. Surg Gynecol Obstet 152:760–764PubMedGoogle Scholar
  55. 55.
    Wells SA (1991) Advances in the operative management of ­persistent hyperparathyroidism. Mayo Clin Proc 66:1175–1177PubMedGoogle Scholar
  56. 56.
    Brennan MF, Marx SJ, Doppman J et al (1981) Results of re-operation for persistent and recurrent hyperparathyroidism. Ann Surg 194:671–676PubMedCrossRefGoogle Scholar
  57. 57.
    Thompson GB, Grant CS, Perrier ND et al (1999) Reoperative parathyroid surgery in the era of sestamibi scanning and intraoperative parathyroid hormone monitoring. Arch Surg 134:699–705PubMedCrossRefGoogle Scholar
  58. 58.
    Grant CS, Van Heerden JA, Charboneau JW et al (1986) Clinical management of persistent and/or recurrent primary hyperparathyroidism. World J Surg 10:555–565PubMedCrossRefGoogle Scholar
  59. 59.
    Bergenfelz A, Forsberg L, Hederstrom E et al (1991) Preoperative localization of enlarged parathyroid glands with ultrasonically guided fine needle aspiration for parathyroid hormone assay. Acta Radiol 32:403PubMedCrossRefGoogle Scholar
  60. 60.
    Marcocci C, Mazzeo S, Bruno-Bossio G et al (1998) Preoperative localization of suspicious parathyroid adenomas by assay of parathyroid hormone in needle aspirates. Eur J Endocrinol 139:72–84PubMedCrossRefGoogle Scholar
  61. 61.
    Gooding GAW, Clark OH, Stark DD et al (1985) Parathyroid aspiration biopsy under ultrasound guidance in the postoperative hyperparathyroid patient. Radiology 155:193PubMedGoogle Scholar
  62. 62.
    Cercueil JP, Jacob D, Verges B et al (1998) Percutaneous ethanol injection into parathyroid adenomas: mid-and long-term results. Eur Radiol 8:1565PubMedCrossRefGoogle Scholar
  63. 63.
    Kendrick ML, Charboneau JW, Curlee KJ, van Heerden JA, Farley DR (2001) Risk of parathyromatosis after fine-needle aspiration. Ann Surg 67:290–293Google Scholar
  64. 64.
    Stephen AE, Milas M, Garner CN, Wagner KE, Siperstein AE (2005) Use of surgeon-performed office ultrasound and ­parathyroid fine needle aspiration for complex parathyroid ­localization. Surgery 138(6):1143–1150; discussion 1150–1151PubMedCrossRefGoogle Scholar
  65. 65.
    Solbiati L, Montali G, Croce F et al (1983) Parathyroid tumors detected by fine-needle aspiration biopsy under ultrasonic guidance. Radiology 148:793–797PubMedGoogle Scholar
  66. 66.
    Caron NR, Sturgeon C, Clark OH (2004) Persistent and recurrent hyperparathyroidism. Curr Treat Options Oncol 5:335–345PubMedCrossRefGoogle Scholar
  67. 67.
    Gross ND, Weissman JL, Veenker E, Cohen JI (2004) The diagnostic utility of computed tomography for preoperative localization in surgery for hyperparathyroidism. Laryngoscope 114:227–231PubMedCrossRefGoogle Scholar
  68. 68.
    van Dalen A, Smit CP, van Vroonhoven TJ, Burger H, de Lange EE (2001) Minimally invasive surgery for solitary parathyroid adenomas in patients with primary hyperparathyroidism: role of US with supplemental CT. Radiology 220:631–639PubMedCrossRefGoogle Scholar
  69. 69.
    Spieth ME, Gough J, Kasner DL (2002) Role of US with supplemental CT for localization of parathyroid adenomas. Radiology 223:878–879PubMedCrossRefGoogle Scholar
  70. 70.
    Profanter C, Wetscher GJ, Gabriel M et al (2004) CT–MIBI image fusion: a new preoperative localization technique for primary, recurrent, and persistent hyperparathyroidism. Surgery 135:157–162PubMedCrossRefGoogle Scholar
  71. 71.
    Gayed IW, Kim EE, Broussard WF et al (2005) The value of 99mTc-sestamibi SPECT/CT over conventional SPECT in the evaluation of parathyroid adenomas and hyperplasia. J Nucl Med 46:248–252PubMedGoogle Scholar
  72. 72.
    Krausz Y, Bettman L, Guralnik L et al (2006) Technetium-99m-MIBI SPECT/CT in primary hyperparathyroidism. World J Surg 30:76–83PubMedCrossRefGoogle Scholar
  73. 73.
    Öksüz MÖ, Dittmann H, Wicke C, Müssig K, Bares R, Pfannenberg C, Eschmann SM (2011) Accuracy of parathyroid imaging: a comparison of planar scintigraphy, SPECT, SPECT-CT and C-11 methionine PET for the detection of parathyroid adenomas and glandular hyperplasia. Diagn Interv Radiol 17(4):297–307PubMedGoogle Scholar
  74. 74.
    Rodgers SE, Hunter GJ, Hamberg LM et al (2006) Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography. Surgery 140:932–940PubMedCrossRefGoogle Scholar
  75. 75.
    Mortenson MM, Evans DB, Lee JE et al (2008) Parathyroid exploration in the reoperative neck: improved pre-operative localization with 4D computed tomography. J Am Coll Surg 206:888–895PubMedCrossRefGoogle Scholar
  76. 76.
    Starker LF, Mahajan A, Björklund P, Sze G, Udelsman R, Carling T (2011) 4D parathyroid CT as the initial ­localization study for patients with de novo primary hyperparathyroidism. Ann Surg Oncol 18(6):1723–1728PubMedCrossRefGoogle Scholar
  77. 77.
    Beland MD, Mayo-Smith WW, Grand DJ, Machan JT, Monchik JM (2011) Dynamic MDCT for localization of occult parathyroid adenomas in 26 patients with primary hyperparathyroidism. AJR Am J Roentgenol 196(1):61–65PubMedCrossRefGoogle Scholar
  78. 78.
    Lubitz CC, Hunter GJ, Hamberg LM, Parangi S, Ruan D, Gawande A, Gaz RD, Randolph GW, Moore FD Jr, Hodin RA, Stephen AE (2010) Accuracy of 4-dimensional computed tomography in poorly localized patients with primary hyperparathyroidism. Surgery 148(6):1129–1137; discussion 1137–1138PubMedCrossRefGoogle Scholar
  79. 79.
    Gimm O, Juhlin C, Morales O, Persson A (2010) Dual-energy computed tomography localizes ectopic parathyroid adenoma. J Clin Endocrinol Metab 95(7):3092–3093PubMedCrossRefGoogle Scholar
  80. 80.
    Coursey CA, Nelson RC, Boll DT, Paulson EK, Ho LM, Neville AM, Marin D, Gupta RT, Schindera ST (2010) Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? Radiographics 30(4):1037–1055PubMedCrossRefGoogle Scholar
  81. 81.
    McDermott VG, Fernandez RJ, Meakem TJ 3rd, Stolpen AH, Spritzer CE, Gefter WB (1996) Preoperative MR imaging in hyperparathyroidism: results and factors affecting parathyroid detection. AJR Am J Roentgenol 166:705–710PubMedGoogle Scholar
  82. 82.
    Lopez Hanninen E, Vogl TJ, Steinmuller T, Ricke J, Neuhaus P, Felix R (2000) Preoperative contrast-enhanced MRI of the parathyroid glands in hyperparathyroidism. Invest Radiol 35:426–430PubMedCrossRefGoogle Scholar
  83. 83.
    Lee VS, Spritzer C (1998) MR imaging of abnormal parathyroid glands. AJR Am J Roentgenol 170:1097PubMedGoogle Scholar
  84. 84.
    Lee VS, Spritzer CE, Coleman RE et al (1996) The complementary roles of fast spin-echo MR imaging and double-phase 99mTc-sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands. AJR Am J Roentgenol 167:1555–1562PubMedGoogle Scholar
  85. 85.
    Wakamatsu H, Noguchi S, Yamashita H et al (2001) Technetium-99m tetrofosmin for parathyroid scintigraphy: a direct comparison with 99mTc-MIBI, 201Tl, MRI and US. Eur J Nucl Med 28:1817–1827PubMedCrossRefGoogle Scholar
  86. 86.
    Ruf J, Lopez Hänninen E, Steinmüller T, Rohlfing T, Bertram H, Gutberlet M, Lemke AJ, Felix R, Amthauer H (2004) Preoperative localization of parathyroid glands. Use of MRI, scintigraphy, and image fusion. Nuklearmedizin 43(3):85–90PubMedGoogle Scholar
  87. 87.
    Gotway MB, Reddy GP, Webb WR, Morita ET, Clark OH, Higgins CB (2001) Comparison between MR imaging and 99mTc MIBI scintigraphy in the evaluation of recurrent or persistent hyperparathyroidism. Radiology 218:783–790PubMedGoogle Scholar
  88. 88.
    Auffermann W, Guis M, Tavares NJ, Clark OH, Higgins CB (1989) MR signal intensity of parathyroid adenomas: correlation with histopathology. AJR Am J Roentgenol 153:873–876PubMedGoogle Scholar
  89. 89.
    De Feo ML, Colagrande S, Biagini C et al (2000) Parathyroid glands: combination of 99m Tc MIBI scintigraphy and US for demonstration of parathyroid glands and nodules. Radiology 214:393PubMedGoogle Scholar
  90. 90.
    Reitz RE, Pollard JJ, Wang CA et al (1969) Localization of parathyroid adenomas by selective venous catheterization and radioimmunoassay. N Engl J Med 281(7):348–351PubMedCrossRefGoogle Scholar
  91. 91.
    Lau JH, Drake W, Matson M (2007) The current role of venous sampling in the localization of endocrine disease. Cardiovasc Intervent Radiol 30(4):555–570PubMedCrossRefGoogle Scholar
  92. 92.
    Doppman JL, Hammond WG (1970) The anatomic basis of parathyroid venous sampling. Radiology 95(3):603–610PubMedGoogle Scholar
  93. 93.
    Buckley O, Brien JO, Doody O, Torreggiani WC (2007) A novel technique in selective venous sampling in the localization of parathyroid tumours utilizing a micro-wire and standardized catheter. Eur Radiol 17(4):1125–1127PubMedCrossRefGoogle Scholar
  94. 94.
    Jones JJ, Brunaud L, Dowd CF, Duh QY, Morita E, Clark OH (2002) Accuracy of selective venous sampling for intact parathyroid hormone in difficult patients with recurrent or persistent hyperparathyroidism. Surgery 132(6):944–950; discussion 950–951PubMedCrossRefGoogle Scholar
  95. 95.
    Reidel MA, Schilling T, Graf S et al (2006) Localization of hyperfunctioning parathyroid glands by selective venous sampling in reoperation for primary or secondary hyperparathyroidism. Surgery 140(6):907–913; discussion 913PubMedCrossRefGoogle Scholar
  96. 96.
    Seehofer D, Steinmuller T, Rayes N et al (2004) Parathyroid hormone venous sampling before reoperative surgery in renal hyperparathyroidism: comparison with noninvasive localization procedures and review of the literature. Arch Surg 139(12):1331–1338PubMedCrossRefGoogle Scholar
  97. 97.
    Jaskowiak N, Norton JA, Alexander HR et al (1996) A ­prospective trial evaluating a standard approach to reoperation for missed parathyroid adenoma. Ann Surg 224(3):308–320; discussion 320–321PubMedCrossRefGoogle Scholar
  98. 98.
    Chaffanjon PC, Voirin D, Vasdev A, Chabre O, Kenyon NM, Brichon PY (2004) Selective venous sampling in recurrent and persistent hyperparathyroidism: indication, technique, and results. World J Surg 28(10):958–961PubMedCrossRefGoogle Scholar
  99. 99.
    Seldinger SI (1954) Localization of parathyroid adenomata by arteriography. Acta Radiol 42(5):353–366PubMedCrossRefGoogle Scholar
  100. 100.
    Doppman JL, Brown EM, Brennan MF, Spiegel A, Marx SJ, Aurbach GD (1979) Angiographic ablation of parathyroid adenomas. Radiology 130(3):577–582PubMedGoogle Scholar
  101. 101.
    Gunther R, Beyer J, Hesch H, Reinwein D (1984) Percutaneous transcatheter ablation of parathyroid gland tumors by alcohol injection and contrast media infusion. Rofo 140(1):27–30PubMedCrossRefGoogle Scholar
  102. 102.
    Miller DL, Doppman JL, Chang R et al (1987) Angiographic ablation of parathyroid adenomas: lessons from a 10-year experience. Radiology 165(3):601–607PubMedGoogle Scholar
  103. 103.
    Ernst S, Cupisti K, Kemper J, Dotzenrath C, Goretzki PE, Furst G (2003) Angiographic ablation of an ectopic mediastinal hyperplastic parathyroid gland using a left internal mammary artery coronary bypass. AJR Am J Roentgenol 181(1):95–97PubMedGoogle Scholar
  104. 104.
    Karstrup S, Hegedus L, Holm HH (1993) Ultrasonically guided chemical parathyroidectomy in patients with primary hyperparathyroidism: a follow-up study. Clin Endocrinol (Oxf) 38(5):523–530CrossRefGoogle Scholar
  105. 105.
    Bennedbaek FN, Karstrup S, Hegedus L (2001) Ultrasound guided laser ablation of a parathyroid adenoma. Br J Radiol 74(886):905–907PubMedGoogle Scholar
  106. 106.
    Sarlos D, Frey LD, Haueisen H, Landmann G, Kots LA, Schaer G (2009) Radioguided occult lesion localization (ROLL) for treatment and diagnosis of malignant and premalignant breast lesions combined with sentinel node biopsy: a prospective clinical trial with 100 patients. Eur J Surg Oncol 35(4):403–408PubMedCrossRefGoogle Scholar
  107. 107.
    Aliyev A, Kabasakal L, Simsek O, Paksoy M, Halac M, Uslu I (2010) Ectopic parathyroid adenoma localized with MIBI scintigraphy and excised with guide of macroaggregated human serum albumin injection. Clin Nucl Med 35(3):151–153PubMedCrossRefGoogle Scholar
  108. 108.
    Lavely WC, Goetze S, Friedman KP, Leal JP, Zhang Z, Garret-Mayer E, Dackiw AP, Tufano RP, Zeiger MA, Ziessman HA (2007) Comparison of SPECT/CT, SPECT, and planar imaging with single- and dual-phase (99m)Tc-sestamibi parathyroid scintigraphy. J Nucl Med 48:1084–1089PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Georg M. Bongartz
    • 1
  • Augustinus L. Jacob
    • 2
  • Sebastian Kos
    • 2
  • Egbert U. Nitzsche
    • 3
  • Mehmet Ö. Öksüz
    • 4
  1. 1.Department of Radiology and Nuclear MedicineUniversity Hospital BaselBaselSwitzerland
  2. 2.Division of Interventional Radiology, Department of Radiology and Nuclear MedicineUniversity Hospital BaselBaselSwitzerland
  3. 3.Department of Nuclear Medicine and PET CenterCantonal Hospital AarauAarauSwitzerland
  4. 4.Department of Radiology and Nuclear MedicineUniversity Hospital BaselBaselSwitzerland

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