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Parathyroid Imaging: Past, Present, and Future

The goal of parathyroid imaging is to identify all sources of excess parathyroid hormone secretion pre-operatively. A variety of imaging approaches have been evaluated and utilized over the years for this purpose. Ultrasound relies solely on structural features and is without radiation, however is l...

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Autores principales: Morris, Michael A., Saboury, Babak, Ahlman, Mark, Malayeri, Ashkan A., Jones, Elizabeth C., Chen, Clara C., Millo, Corina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914059/
https://www.ncbi.nlm.nih.gov/pubmed/35283807
http://dx.doi.org/10.3389/fendo.2021.760419
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author Morris, Michael A.
Saboury, Babak
Ahlman, Mark
Malayeri, Ashkan A.
Jones, Elizabeth C.
Chen, Clara C.
Millo, Corina
author_facet Morris, Michael A.
Saboury, Babak
Ahlman, Mark
Malayeri, Ashkan A.
Jones, Elizabeth C.
Chen, Clara C.
Millo, Corina
author_sort Morris, Michael A.
collection PubMed
description The goal of parathyroid imaging is to identify all sources of excess parathyroid hormone secretion pre-operatively. A variety of imaging approaches have been evaluated and utilized over the years for this purpose. Ultrasound relies solely on structural features and is without radiation, however is limited to superficial evaluation. 4DCT and 4DMRI provide enhancement characteristics in addition to structural features and dynamic enhancement has been investigated as a way to better distinguish parathyroid from adjacent structures. It is important to recognize that 4DCT provides valuable information however results in much higher radiation dose to the thyroid gland than the other available examinations, and therefore the optimal number of phases is an area of controversy. Single-photon scintigraphy with 99mTc-Sestamibi, or dual tracer 99mTc-pertechnetate and 99mTc-sestamibi with or without SPECT or SPECT/CT is part of the standard of care in many centers with availability and expertise in nuclear medicine. This molecular imaging approach detects cellular physiology such as mitochondria content found in parathyroid adenomas. Combining structural imaging such as CT or MRI with molecular imaging in a hybrid approach allows the ability to obtain robust structural and functional information in one examination. Hybrid PET/CT is widely available and provides improved imaging and quantification over SPECT or SPECT/CT. Emerging PET imaging techniques, such as 18F-Fluorocholine, have the exciting potential to reinvent parathyroid imaging. PET/MRI may be particularly well suited to parathyroid imaging, where available, because of the ability to perform dynamic contrast-enhanced imaging and co-registered 18F-Fluorocholine PET imaging simultaneously with low radiation dose to the thyroid. A targeted agent specific for a parathyroid tissue biomarker remains to be identified.
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spelling pubmed-89140592022-03-12 Parathyroid Imaging: Past, Present, and Future Morris, Michael A. Saboury, Babak Ahlman, Mark Malayeri, Ashkan A. Jones, Elizabeth C. Chen, Clara C. Millo, Corina Front Endocrinol (Lausanne) Endocrinology The goal of parathyroid imaging is to identify all sources of excess parathyroid hormone secretion pre-operatively. A variety of imaging approaches have been evaluated and utilized over the years for this purpose. Ultrasound relies solely on structural features and is without radiation, however is limited to superficial evaluation. 4DCT and 4DMRI provide enhancement characteristics in addition to structural features and dynamic enhancement has been investigated as a way to better distinguish parathyroid from adjacent structures. It is important to recognize that 4DCT provides valuable information however results in much higher radiation dose to the thyroid gland than the other available examinations, and therefore the optimal number of phases is an area of controversy. Single-photon scintigraphy with 99mTc-Sestamibi, or dual tracer 99mTc-pertechnetate and 99mTc-sestamibi with or without SPECT or SPECT/CT is part of the standard of care in many centers with availability and expertise in nuclear medicine. This molecular imaging approach detects cellular physiology such as mitochondria content found in parathyroid adenomas. Combining structural imaging such as CT or MRI with molecular imaging in a hybrid approach allows the ability to obtain robust structural and functional information in one examination. Hybrid PET/CT is widely available and provides improved imaging and quantification over SPECT or SPECT/CT. Emerging PET imaging techniques, such as 18F-Fluorocholine, have the exciting potential to reinvent parathyroid imaging. PET/MRI may be particularly well suited to parathyroid imaging, where available, because of the ability to perform dynamic contrast-enhanced imaging and co-registered 18F-Fluorocholine PET imaging simultaneously with low radiation dose to the thyroid. A targeted agent specific for a parathyroid tissue biomarker remains to be identified. Frontiers Media S.A. 2022-02-25 /pmc/articles/PMC8914059/ /pubmed/35283807 http://dx.doi.org/10.3389/fendo.2021.760419 Text en Copyright © 2022 Morris, Saboury, Ahlman, Malayeri, Jones, Chen and Millo https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Morris, Michael A.
Saboury, Babak
Ahlman, Mark
Malayeri, Ashkan A.
Jones, Elizabeth C.
Chen, Clara C.
Millo, Corina
Parathyroid Imaging: Past, Present, and Future
title Parathyroid Imaging: Past, Present, and Future
title_full Parathyroid Imaging: Past, Present, and Future
title_fullStr Parathyroid Imaging: Past, Present, and Future
title_full_unstemmed Parathyroid Imaging: Past, Present, and Future
title_short Parathyroid Imaging: Past, Present, and Future
title_sort parathyroid imaging: past, present, and future
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914059/
https://www.ncbi.nlm.nih.gov/pubmed/35283807
http://dx.doi.org/10.3389/fendo.2021.760419
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