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

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Abstract

Introduction

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.

Localization

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.

Review

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.

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Authors and Affiliations

  1. Service of Nuclear Medicine, S. Maria della Misericordia Hospital, Viale Tre Martiti, 140, 45100, Rovigo, Italy

    Domenico Rubello

  2. Nuclear Medicine Service, Department of Veterans Affairs Health System, Ann Arbor, MI, USA

    Milton D. Gross

  3. Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy

    Giuliano Mariani

  4. Department of Nuclear Medicine, Hammersmith Hospital, London, UK

    Adil AL-Nahhas

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  1. Domenico Rubello
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  2. Milton D. Gross
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  4. Adil AL-Nahhas
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Correspondence to Domenico Rubello.

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Rubello, D., Gross, M.D., Mariani, G. et al. Scintigraphic techniques in primary hyperparathyroidism: from pre-operative localisation to intra-operative imaging. Eur J Nucl Med Mol Imaging 34, 926–933 (2007). https://doi.org/10.1007/s00259-007-0388-3

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