Journal-based CME Course: Intentional Imaging for Primary Hyperparathyroidism

Activity ID

15206

Expires

August 20, 2029

Format Type

Journal-based

CME Credit

1

Fee

$30

CME Provider: JAMA Otolaryngology – Head & Neck Surgery

Description of CME Course

Importance  Preoperative parathyroid localization has been a great advance in the success of surgery for patients with primary hyperparathyroidism (pHPT) over the past 40 years.

Objective  To highlight the amount of radiation exposure from contemporary parathyroid imaging options and to suggest intentional imaging use in planning for parathyroidectomy.

Evidence Review  Contemporary parathyroid imaging modalities and their respective radiation exposure were reviewed. The analysis focused on patients undergoing preoperative parathyroid imaging related to pHPT and persistent/recurrent pHPT. Exposure of patients to ionizing radiation from devices and radiotracers measured in mSv was reported.

Findings  The parathyroid imaging recommendations include ultrasonography (0 mSv), technetium Tc 99m sestamibi single-photon emission computed tomography (SPECT) with or without computed tomography (CT) (8.6-12.1 mSv), and second-line/complex imaging for patients undergoing revision parathyroid surgery: 4-dimensional CT (9.3-20.2 mSv) or choline-based positron emission tomography (PET) with or without CT (6.7-11.8 mSv).

Conclusions and Relevance  Imaging should be conducted only when the diagnosis is confirmed. When making decisions about imaging, consider radiation exposure, sensitivity/specificity for adenoma detection, local expertise in the imaging modality, and cost.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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