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Head Neck. 2019 Apr 19. doi: 10.1002/hed.25781. [Epub ahead of print]

American Head and Neck Society Endocrine Surgery Section update on parathyroid imaging for surgical candidates with primary hyperparathyroidism.

Author information

1
Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas.
2
Section of Endocrine Surgery, Department of Surgery, University of Chicago, Chicago, Illinois.
3
Section of Head and Neck Surgery, UC San Diego Health System, San Diego, California.
4
Department of Nuclear Medicine, MD Anderson Cancer Center, Houston, Texas.
5
Otolaryngology - Head and Neck Surgery, Penn State College of Medicine, Hershey, Pennsylvania.
6
Division of Head & Neck Surgery, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
7
Department of Surgical Oncology, MD Anderson Cancer Center, Houston, Texas.
8
Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
9
Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University School of Medicine, Portland, Oregon.
10
Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan.
11
Head and Neck Surgical Oncology, Baptist MD Anderson Cancer Center, Jacksonville, Florida.
12
Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
13
Division of Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.
14
Department of Otolaryngology, Medical College of Georgia, Augusta, Georgia.
15
Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas.
16
Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York City, New York.
17
Division of Head and Neck Endocrine Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.

Abstract

Health care consumer organizations and insurance companies increasingly are scrutinizing value when considering reimbursement policies for medical interventions. Recently, members of several American Academy of Otolaryngology-Head & Neck Surgery (AAO-HNS) committees worked closely with one insurance company to refine reimbursement policies for preoperative localization imaging in patients undergoing surgery for primary hyperparathyroidism. This endeavor led to an AAO-HNS parathyroid imaging consensus statement (https://www.entnet.org/content/parathyroid-imaging). The American Head and Neck Society Endocrine Surgery Section gathered an expert panel of authors to delineate imaging options for preoperative evaluation of surgical candidates with primary hyperparathyroidism. We review herein the current literature for preoperative parathyroid localization imaging, with discussion of efficacy, cost, and overall value. We recommend that planar sestamibi imaging, single photon emission computed tomography (SPECT), SPECT/CT, CT neck/mediastinum with contrast, MRI, and four dimensional CT (4D-CT) may be used in conjunction with high-resolution neck ultrasound to preoperatively localize pathologic parathyroid glands. PubMed literature on parathyroid imaging was reviewed through February 1, 2019.

KEYWORDS:

parathyroid imaging; parathyroid imaging modalities; review; value in health care

PMID:
31002214
DOI:
10.1002/hed.25781

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