Parathyroid imaging studies have historically played an essential role in the localisation of parathyroid pathology, but with the advent of the minimally invasive parathyroidectomy, the role of preoperative localisation has now become crucial to a successful surgical outcome. A number of noninvasive structural and functional imaging methodologies are currently available for localising the culprit parathyroid lesion(s). These include ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), and radionuclide scintigraphy. Parathyroid scintigraphy and ultrasonography are usually the first-line imaging modalities, whereas MRI and contrast-enhanced CT play a corroborative and problem-solving role when the results of the initial imaging studies are negative, equivocal, or incongruous.
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