Parathyroid ultrasonography: the evolving role of the radiologist

Sung, Jin Yong

doi:10.14366/usg.14071

Cited by 47 publications

(34 citation statements)

References 42 publications

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“…In this study, normal parathyroid glands measured by intraoperative and percutaneous US ranged between 2.1 and 10.3 mm. This range is similar to anatomic and histopathologic reports of about 2 to 7 mm and theoretically within the resolution of the high‐frequency transducers commonly used for thyroid and neck tissue …”

Section: Discussionsupporting

confidence: 86%

“…The typical description of normal parathyroid glands is usually expressed with an emphasis on the difficulties in distinguishing them from neighboring fibrous and fatty tissues . A parathyroid gland that is visible on US imaging is usually thought to be suspicious for the presence of a pathologic entity . In recent reports, a few authors described the normal parathyroid as an isoechoic or hyperechoic structure relative to the adjacent thyroid, whereas the evidence of these descriptions was not clarified .…”

mentioning

confidence: 99%

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Study of the Ultrasound Appearance of the Normal Parathyroid Using an Intraoperative Procedure

Xia

Zhu

et al. 2018

J of Ultrasound Medicine

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

Study of the Ultrasound Appearance of the Normal Parathyroid Using an Intraoperative Procedure

Xia

Zhu

et al. 2018

J of Ultrasound Medicine

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“…Normal parathyroid glands are shaped like small flattened disks, measuring approximately 6 mm in the craniocaudal dimension and 3 mm in the transverse dimension (6). They are not usually identified on neck ultrasound (US), making a visible parathyroid gland suspicious for the presence of a pathological entity (7).…”

Section: Introductionmentioning

confidence: 99%

“…They are not usually identified on neck ultrasound (US), making a visible parathyroid gland suspicious for the presence of a pathological entity (7). Due to the increased use of high-resolution US, an increasing number of parathyroid incidentalomas are being detected (6). The frequency of observing incidental parathyroid tumors is <1% (8,9).…”

Section: Introductionmentioning

confidence: 99%

Occult Primary Hyperparathyroidism: A Case Report and Review of Parathyroid Ultrasonography

Moccia¹,

Miller

Vaz

2020

AACE Clinical Case Reports

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Objective: To discuss the diagnosis and management of occult primary hyperparathyroidism. Methods: We present the biochemical and radiologic evaluation, treatment, and outcome of a woman with occult primary hyperparathyroidism which presented as an unusual neck mass on ultrasound. We also present a relevant literature review. Results: A 52-year-old female presented with Hashimoto thyroiditis and a 1.2-cm, hypoechoic oval nodule in the left upper lateral portion of the thyroid. She returned a decade later with a 2.2-cm, hypervascular mass on ultrasound. Parathyroid hormone was mildly elevated at 90 pg/mL (reference range is 15 to 65 pg/mL), but she had persistently normal levels of total serum calcium at 9.9 mg/dL (reference range is 8.7 to 10.3 mg/dL), phosphorus at 3.5 mg/dL (reference range is 2.1 to 4.5 mg/dL), and albumin at 4.4 g/dL (reference range is 3.6 to 4.8 g/dL). She had elevated ionized calcium of 5.9 mg/dL (reference range is 4.5 to 5.6 mg/dL). Computed tomography with contrast of the neck revealed an enhancing oval lesion abutting the superior pole of the left thyroid with attenuation characteristics similar though slightly different from the thyroid. 99mTc-Sestamibi scan showed increased uptake posterior to the superior aspect of the left thyroid. Bone densitometry showed osteoporosis of the left distal radius and osteopenia of the left femoral neck. Minimally invasive radio-guided parathyroidectomy was performed with normalization of parathyroid hormone. Pathology confirmed a 1.715-g parathyroid adenoma. Conclusion: Despite normal total calcium levels, clinically significant primary hyperparathyroidism may present as a large adenoma which could appear as a hypervascular neck mass on ultrasound. A high index of suspicion based on ultrasound features and measurement of ionized calcium may be helpful in diagnosing occult, but clinically relevant primary hyperparathyroidism.

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“…The main challenge is the preoperative localization of parathyroid pathology. Ultrasonography [7,8], magnetic resonance imaging (MRI) [9], computed tomography (CT), and scintigraphy [10] are used as preoperative imaging techniques. Modern imaging approaches use Single-Photon Emission Computed Tomography (SPECT) or Single-Photon Emission Computed Tomography combined with Computed Tomography (SPECT/CT) [11,12] for improved localization.…”

Section: Introductionmentioning

confidence: 99%

Estimation of Parameters of Parathyroid Glands Using Particle Swarm Optimization and Multivariate Generalized Gaussian Function Mixture

et al. 2019

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Featured Application: The analyzed technique allows the estimation of parameters of small objects from SPECT volumes. Data analysis was based on Particle Swarm Optimization that reduces error between assumed model and measurements. Analysis by Synthesis was used for the estimation of parameters. Abstract: The paper introduces a fitting method for Single-Photon Emission Computed Tomography (SPECT) images of parathyroid glands using generalized Gaussian function for quantitative assessment of preoperative parathyroid SPECT/CT scintigraphy results in a large patient cohort. Parathyroid glands are very small for SPECT acquisition and the overlapping of 3D distributions was observed. The application of multivariate generalized Gaussian function mixture allows modeling, but results depend on the optimization algorithm. Particle Swarm Optimization (PSO) with global best, ring, and random neighborhood topologies were compared. The obtained results show benefits of random neighborhood topology that gives a smaller error for 3D position and the position estimation was improved by about 3% voxel size, but the most important is the reduction of processing time to a few minutes, compared to a few hours in relation to the random walk algorithm. Moreover, the frequency of obtaining low MSE values was more than two times higher for this topology. The presented method based on random neighborhood topology allows quantifying activity in a specific voxel in a short time and could be applied it in clinical practice.

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Parathyroid ultrasonography: the evolving role of the radiologist

Cited by 47 publications

References 42 publications

Study of the Ultrasound Appearance of the Normal Parathyroid Using an Intraoperative Procedure

Study of the Ultrasound Appearance of the Normal Parathyroid Using an Intraoperative Procedure

Occult Primary Hyperparathyroidism: A Case Report and Review of Parathyroid Ultrasonography

Estimation of Parameters of Parathyroid Glands Using Particle Swarm Optimization and Multivariate Generalized Gaussian Function Mixture

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