All patients undergoing imaging in the setting of THPT should have biochemically proven disease, as imaging has no role in confirming or excluding the diagnosis [11]. As such, assessing the imaging test specificity and negative predictive value is not clinically relevant. THPT is typically a disorder of MGD in which the role of initial imaging is to accurately identify all eutopic and potential ectopic or supernumerary glands in an attempt to guide the surgical approach [12-14]; accordingly, these criteria focus on imaging test sensitivity and PPV. It is possible that multiple imaging modalities may be utilized in combination during the initial imaging evaluation of THPT in an attempt to maximize the accuracy and confidence of parathyroid via concordant imaging results. This is inferred from data regarding PHPT [16-23] and SHPT [12] showing improved sensitivity and PPV in parathyroid lesion localization with a combination of examinations over each examination in isolation. Parathyroid Adenoma CT Neck There is no relevant literature regarding the use of CT neck in the evaluation of THPT. MRI Neck There is no relevant literature regarding the use of MRI neck performed without IV contrast, with IV contrast, or without and with IV contrast in the evaluation of THPT. Sestamibi Dual-Phase Scan Neck There is no relevant literature regarding the use of planar sestamibi dual-phase scan neck in the evaluation of THPT. Sestamibi Scan and I-123 Thyroid Scan There is no relevant literature regarding the use of planar sestamibi scan and I-123 thyroid scan in the evaluation of THPT. Sestamibi Scan and I-123 Thyroid Scan with SPECT or SPECT/CT Neck There is no relevant literature regarding the use of sestamibi scan and I-123 thyroid scan with SPECT or SPECT/CT in the evaluation of THPT. Sestamibi Scan and Pertechnetate Thyroid Scan There is no relevant literature regarding the use of planar sestamibi scan and pertechnetate thyroid scan in the evaluation of THPT.
Parathyroid Adenoma. All patients undergoing imaging in the setting of THPT should have biochemically proven disease, as imaging has no role in confirming or excluding the diagnosis [11]. As such, assessing the imaging test specificity and negative predictive value is not clinically relevant. THPT is typically a disorder of MGD in which the role of initial imaging is to accurately identify all eutopic and potential ectopic or supernumerary glands in an attempt to guide the surgical approach [12-14]; accordingly, these criteria focus on imaging test sensitivity and PPV. It is possible that multiple imaging modalities may be utilized in combination during the initial imaging evaluation of THPT in an attempt to maximize the accuracy and confidence of parathyroid via concordant imaging results. This is inferred from data regarding PHPT [16-23] and SHPT [12] showing improved sensitivity and PPV in parathyroid lesion localization with a combination of examinations over each examination in isolation. Parathyroid Adenoma CT Neck There is no relevant literature regarding the use of CT neck in the evaluation of THPT. MRI Neck There is no relevant literature regarding the use of MRI neck performed without IV contrast, with IV contrast, or without and with IV contrast in the evaluation of THPT. Sestamibi Dual-Phase Scan Neck There is no relevant literature regarding the use of planar sestamibi dual-phase scan neck in the evaluation of THPT. Sestamibi Scan and I-123 Thyroid Scan There is no relevant literature regarding the use of planar sestamibi scan and I-123 thyroid scan in the evaluation of THPT. Sestamibi Scan and I-123 Thyroid Scan with SPECT or SPECT/CT Neck There is no relevant literature regarding the use of sestamibi scan and I-123 thyroid scan with SPECT or SPECT/CT in the evaluation of THPT. Sestamibi Scan and Pertechnetate Thyroid Scan There is no relevant literature regarding the use of planar sestamibi scan and pertechnetate thyroid scan in the evaluation of THPT.