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Nuclear Imaging and Minimally Invasive Surgery in the Management of Hyperparathyroidism^*

Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York

Correspondence: For correspondence or reprints contact: Ashok R. Shaha, FACS Head and Neck Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY. E-mail: shahaa{at}mskcc.org

Primary hyperparathyroidism is the most common cause of hypercalcemia, and the treatment is primarily surgical. Because of biochemical screening, more patients now present with asymptomatic primary hyperparathyroidism, and consensus guidelines have been developed for the treatment of these patients. There is now considerable interest in minimally invasive approaches to the treatment of hyperparathyroidism. Sestamibi scanning as a localizing study, used in combination with anatomic imaging and intraoperative rapid parathyroid hormone assays, has enabled focused surgical approaches. Patients with localizing studies that indicate a single parathyroid adenoma are candidates for such approaches, including unilateral neck exploration, minimally invasive single-gland exploration, or endoscopic exploration instead of the traditional approach of bilateral neck exploration. Nuclear imaging is also critical to the successful management of patients with persistent or recurrent hyperparathyroidism.

Key Words: endocrinology • hyperparathyroidism • sestamibi • endoscopic exploration • minimally invasive single-gland exploration • parathyroid hormone assays

^* NOTE: FOR CE CREDIT, YOU CAN ACCESS THIS ACTIVITY THROUGH THE SNM WEB SITE (http://www.snm.org/ce_online) THROUGH NOVEMBER 2009.

The authors have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. No other potential conflict of interest relevant to this article was reported.

COPYRIGHT © 2008 by the Society of Nuclear Medicine, Inc.

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