David Aamodt MD, Presenter: Nothing to Disclose

Christopher Harker Hunt MD, Abstract Co-Author: Nothing to Disclose

Geoffrey Bates Johnson MD, PhD, Abstract Co-Author: Nothing to Disclose

Patrick James Peller MD, Abstract Co-Author: Speakers Bureau, Eli Lilly and Company

To review the use of multimodality imaging in complex cases of hyperparathyroidism which have failed initial surgical and medical treatment

1. Review the rationale behind imaging with CT, MRI, ultrasound, and nuclear medicine in cases of primary and secondary hyperparathyroidism. 2. Demonstrate the utility of advanced imaging with dynamic CT, MRI, and dual isotope nuclear medicine scintigraphy in more complex cases, especially in those that have failed initial therapy. 3. Illustrate potential mimics of disease as well potential pitfalls in locating ectopic disease. 4. Discuss and illustrate the difference between multimodality imaging protocols in primary and secondary hyperparathyroidism.

The major teaching points of this educational exhibit are: 1. While uncomplicated cases of primary hyperparathyroidism can be treated with direct surgical exploration without imaging, recurrent/residual disease can be a complex problem to image and treat. 2. Multimodality imaging with dynamic CT, MRI, ultrasound, and/or dual isotope nuclear medicine scintigraphy can help localize ectopic adenomas and multifocal disease. 3. The ability to effectively utilize all these modalities when necessary can help limit surgical exploration, treat recurrent disease, and deal with more complex cases, including secondary hyperparathyroidism.

Aamodt, D, Hunt, C, Johnson, G, Peller, P, Multimodality Imaging of the Parathyroid Glands prior to Reoperation for Hyperparathyroidism.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13028675.html