Our Summary

This research paper discusses the importance of parathyroid imaging in the treatment of primary hyperparathyroidism (pHPT), a condition caused by an overactive parathyroid gland. The most common treatment is minimally invasive surgery, but this requires the accurate detection and location of the overactive gland beforehand. If the problematic gland isn’t properly identified, a more invasive surgery may be needed, which comes with higher risks. Parathyroid imaging is also useful in cases of secondary hyperparathyroidism or hereditary disorders, as it allows for the detection of abnormal or extra glands.

The European Association of Nuclear Medicine recently updated its guidelines on parathyroid imaging. These guidelines aim to clarify the role and pros and cons of different imaging techniques, and to encourage high-quality performance of these tests. This paper provides a summary of these new guidelines and highlights how they differ from previous guidelines.

FAQs

  1. What is the importance of parathyroid imaging in the treatment of primary hyperparathyroidism?
  2. What are the new guidelines from the European Association of Nuclear Medicine on parathyroid imaging?
  3. How does inaccurate detection of the overactive gland affect the treatment of primary hyperparathyroidism?

Doctor’s Tip

One helpful tip a doctor might tell a patient about parathyroidectomy is to follow all pre-operative instructions carefully. This may include fasting before the surgery, stopping certain medications, and avoiding certain foods or drinks. Following these instructions can help ensure a successful surgery and reduce the risk of complications. Additionally, it is important to discuss any concerns or questions with your healthcare provider before the surgery to ensure you are fully informed and prepared for the procedure.

Suitable For

Patients who are typically recommended for parathyroidectomy include those with primary hyperparathyroidism who have persistent or symptomatic disease, those with severe hypercalcemia, those with a high risk of developing complications from hyperparathyroidism, and those who are young and otherwise healthy. Additionally, patients with secondary hyperparathyroidism or hereditary disorders may also be recommended for parathyroidectomy if imaging reveals abnormal or extra glands. Overall, the decision to recommend parathyroidectomy is based on the individual patient’s symptoms, risk factors, and imaging results.

Timeline

Before parathyroidectomy:

  1. Patient presents with symptoms of primary hyperparathyroidism such as fatigue, weakness, bone pain, kidney stones, and frequent urination.
  2. Blood tests show elevated levels of calcium and parathyroid hormone.
  3. Imaging tests such as ultrasound, sestamibi scan, or CT scan are performed to locate the overactive parathyroid gland.
  4. Once the problematic gland is identified, the patient undergoes minimally invasive parathyroidectomy surgery.

After parathyroidectomy:

  1. The surgery is successful in removing the overactive parathyroid gland.
  2. Patient may experience a decrease in symptoms such as fatigue and bone pain.
  3. Blood tests show a normalization of calcium and parathyroid hormone levels.
  4. Patient undergoes follow-up appointments to monitor their calcium levels and overall health post-surgery.

What to Ask Your Doctor

  1. What imaging tests will be performed before the surgery to locate the overactive parathyroid gland?
  2. How accurate are these imaging tests in identifying the problematic gland?
  3. What are the risks associated with not accurately locating the overactive gland before surgery?
  4. Are there any alternative treatment options for primary hyperparathyroidism?
  5. How will the results of the imaging tests affect the surgical approach and outcome?
  6. What is the success rate of minimally invasive parathyroidectomy in treating primary hyperparathyroidism?
  7. How long is the recovery period after parathyroidectomy surgery?
  8. What are the potential complications or side effects of parathyroidectomy?
  9. Will I need to take any medication or follow a specific diet after the surgery?
  10. How often will follow-up appointments be needed to monitor my condition post-surgery?

Reference

Authors: Petranović Ovčariček P, Giovanella L, Hindie E, Huellner MW, Talbot JN, Verburg FA. Journal: Q J Nucl Med Mol Imaging. 2022 Jun;66(2):93-103. doi: 10.23736/S1824-4785.22.03427-6. Epub 2022 Feb 15. PMID: 35166093