PT  - JOURNAL ARTICLE
AU  - Benjamin L. Judson
AU  - Ashok R. Shaha
TI  - Nuclear Imaging and Minimally Invasive Surgery in the Management of Hyperparathyroidism
AID  - 10.2967/jnumed.107.050237
DP  - 2008 Nov 01
TA  - Journal of Nuclear Medicine
PG  - 1813--1818
VI  - 49
IP  - 11
4099  - http://jnm.snmjournals.org/content/49/11/1813.short
4100  - http://jnm.snmjournals.org/content/49/11/1813.full
SO  - J Nucl Med2008 Nov 01; 49
AB  - 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.