PARATHYROID IMAGING

Developments in technology mean that it is now possible to localize ab normal parathyroid glands by a variety of imaging methods. There remai n a number of unresolved issues. With all commonly used methods (radio nuclide imaging, ultrasound, computed tomography and magnetic resonanc e imaging), there are wide variations in sensitivity of detection of g lands, and in many cases this variation is not explained satisfactoril y. The necessity for imaging is questioned by many parathyroid surgeon s, particularly before a first operation. However, parathyroid surgery is itself changing, with a trend towards more limited neck exploratio n, which requires localization of the glands pre-operatively. This rev iew describes the methods available for localizing parathyroid glands, with their advantages and limitations, and discusses the role of the techniques prior to surgery.