[Current status of preoperative localization in primary hyperparathyroidism (author's transl)]

Since Seldinger demonstrated in 1953 parathyroid adenomas by arteriography, numerous localizing procedures have been advocated. Based on our experience with selective venous sampling for measurement of parathyroid hormone by radioimmunoassay, selective arteriography, pneumomediastinography and scanning with 75Se-selenomethionine, a survey on localization techniques used up to now is given and their value and applications are discussed. Preoperative localization of parathyroid tissue should be limited to patients with previous unsuccessful surgery. In these cases we perform selective venous sampling following selective arteriography for demonstration of the venous drainage pattern and subsequent venous catheterization. Pneumomediastinography is recommended in suspected mediastinal parathyroid adenoma. Scanning with 75Se-selenomethionine is not in use because of its limited success.