Abstract
The parathyroid glands arise from the pharyngeal pouches; usually, there are four such glands but the incidence of a supernumerous gland is 2–5% [1, 2]. The parathyroid glands are usually localized behind the thyroid gland. The two behind the upper lobe are also called the superior glands or P4 (originating from the fourth pouch), and the two behind/beyond the lower lobe are also referred to as the inferior glands or P3 (originating from the third pouch) [1, 2]. It is worth noting that the location of normal inferior parathyroid glands is more variable than that of the superior glands, probably due to their longer developmental pathway and more difficult developmental migration process. Consequently, the P3 glands can be intrathyroidal, within the thyrothymic ligament, within the thymus, or in the mediastinum. The parathyroid glands are generally found in the peri-thyroid sheath but may also occur outside the thyroid capsule or, very rarely, in a subcapsular site [1–5].
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References
Mariani G, Seza A Gulec, Rubello D et al (2003) Preoperative localization and radioguided parathyroid surgery. J Nucl Med 44:1443–1458
Elgazzar A (2001) Parathyroid gland. In: Elgazzar A (ed) The pathophysiologic basis of nuclear medicine. Springer-Verlag, Berlin Heidelberg New York, pp 141–146
Giordano A, Rubello D (2003) Le Paratiroidi — sez. endocrinologia. In: Dondi M, Giubbini R (ed) Medicina nucleare nella pratica clinica. Patron, Bologna, pp 171–183
Grassetto G, Alavi A, Rubello D (2008) PET and parathyroid. PET Clinics 2:3X5–393
Guyton A (1995) Ormone paratiroideo. Calcitonina. Metabolismo de. calcio e del fosforo. Vitamina D. Osso e denti. In: Guyton A (ed) Trattato di fisiologia medica. Piccin, Padova, pp 948–996
DeLellis RA, Mazzaglia P, Mangray (2008) Primary hyperparathyroidism: a current perspective. Arch Pathol Lab Med 132(8): 1251–1262
DeLellis RA (2005) Parathyroid carcinoma: an overview. Adv Anat Pathol 12(2):53–61
Doppman J (1986) Reoperative parathyroid surgery: localization procedures, parathyroid surgery. Prog Surg 18:117–136
O’Doherty M J, Kettle AG (2003) Parathyroid imaging: preoperative localisation. Nucl Med Commun 24:125–131
Beggs AD, Hain SF (2005) Localization of parathyroid adenomas using 1 lCmethionine positron emission tomography. Nucl Med Commun 26: 133–136
Otto D, Boerne AR, Hofmann M et al (2004) Pre-operative localization of hyperfunctional parathyroid tissue with 11C-methionine PET. Eur J Nucl Med Mol Imaging 31:1405–1412
Giordano A, Rubello D, Casara D (2001) New trends in parathyroid scintigraphy. Eur J Nucl Med 28:1409–1420
Rubello D (2006) How should the “optimal” pre-operative localizing imaging work-up in hyperparathyroid patients be? J Endocrinol Invest 29(9):854–856
Coakley AJ, Kettle AG, Wells CP et al (1989) Tc-99m-sestamibi: a new agent for parathyroid imaging. Nucl Med Commun 10: 791–794
O’Doherty M J, Kettle A G, Wells PC et al (1992) Parathyroid imaging with technetium-99m-sestamibi: preoperative localisation and tissue uptake studies. J Nucl Med 33: 313–318
Hindié E, Melliere D, Simon D et al (1995) Primary hyperparathyroidism: is technetium 99m-Sestamibi/iodine-123 subtraction scanning the best procedure to locate enlarged glands before surgery? J Clin Endocrinol Metab 80:302–307
Ferlin G, Borsato N, Camerani M et al (1983) New perspectives in localising enlarged parathyroids by technetium-thallium subtraction scan. J Nucl Med 24:438–431
Fjeld J G, Erichson K, Pfeffer PF (1997) Tc-99m-tetrofosmin for parathyroid imaging: comparison with sestamibi. J Nucl Med 38:831–834
Hindié E, Mellière D, Jeanguillaume C et al (1996) Acquisition double-fenêtre 99mTc-MIBI/123I vs 99mTc-MIBI seul dans l’hyperparathyroïdie primitive. Communication Orale, XXXVe Colloque de Médecine Nucléaire, Lille, pp 15–18
Hindié E, Mellière D, Jeanguillaume C et al (1998) Parathyroid imaging using simultaneous double-window recording of technetium-99m-sestamibi and iodine-123. J Nucl Med 39:1100–1105
Johnston LB, Carroll MJ, Britton KE et al (1996) The accuracy of parathyroid gland localization in primary hyperparathyroidism using sestamibi radionuclide imaging. J Clin Endocrinol Metab 81:346–352
Rubello D, Saladini G, Casara D et al (2000) Parathyroid imaging with pertechnetate plus perchlorate/MIBI subtraction scintigraphy: a fast and effective technique. Clin Nucl Med 25:527–531
Geatti O, Shapiro B, Orsolon PG et al (1994) Localization of parathyroid enlargement: experience with technetium-99m methoxyisobutylisonitrile and thallium-201 scintigraphy, ultrasonography and computed tomography. Eur J Nucl Med 21:17–22
Casara D, Rubello D, Saladini G et al (1992) Imaging procedures in evaluation of hyperparathyroidism: the role of scintigraphy with 99mTc-MIBI. In: Ravelli E, Samori G (ed) Primary and secondary hyperparathyroidism. Wichtig, Milan, pp 133–136
Taillefer R, Boucher Y, Potvin C et al (1992) Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with Technetium-99m-Sestamibi (double-phase study). J Nucl Med 33:1801–1807
Torregrosa JV, Fernandez-Cruz L, Canaleyo A et al (2000) 99mTc-sestamibi scintigraphy and cell cycle in parathyroid glands of secondary hyperparathyroidism. World J Surg 24:1386–1390
Billotey C, Sarfati E, Aurengo A et al (1996) Advantages of SPECT in technetium-99m-Sestamibi parathyroid scintigraphy J Nucl Med 37:1773–1778
Lange-Nolde A, Zajic T, Slawik M et al (2006) PET with 18F-DOPA in the imaging of parathyroid adenoma in patients with primary hyperparathyroidism. A pilot study. Nuklearmedizin 45:193–196
AACE/AAES Task force on primary hyperparathyroidism (2005) The American Association of Clinical Endocrinologists and the American Association of Endocrine Surgeons position statement on the diagnosis and management of primary hyperparathyroidism. Endoer Pract 11:49–54
Ugur O, Bozkurt MF, Rubello D (2008) Nuclear medicine techniques for radioguided surgery of hyperparathyroidism. Minerva Endocrinol 33:1–10
Norman J, Chheda H (1997) Minimally invasive parathyroidectomy facilitated by intraoperative nuclear mapping. Surgery 122:998–1004
Casara D, Rubello D, Piotto A et al (2000) Tc99m-MIBI radioguided minimally invasive parathyroid surgery planned on the basis of a preoperative combined Tc99m-pertechnetate/Tc-99m MIBI and ultrasound imaging protocol. Eur J Nucl Med 27:1300–1304
Bozkurt MF, Ugur O, Hamaloglu E et al (2003) Optimization of the gamma probe-guided parathyroidectomy. Am Surg 69:720–725
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Marzola, M.C., Grassetto, G., Rubello, D. (2009). Nuclear Medicine in the Diagnosis and Treatment of Hyperparathyroidism. In: Hodler, J., Zollikofer, C.L., Von Schulthess, G.K. (eds) Musculoskeletal Diseases 2009–2012. Springer, Milano. https://doi.org/10.1007/978-88-470-1378-0_36
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DOI: https://doi.org/10.1007/978-88-470-1378-0_36
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