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Updated: Dec 22, 2025
Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
Preoperative parathyroid localization does not improve surgical outcomes for patients with primary
Jessica M Fazendin1, Brenessa Lindeman1, Herbert Chen1
1The Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL, USA.
Background:
Most patients with primary hyperparathyroidism undergo localization prior to operation with variable success. Therefore, in this study we investigated the safety of parathyroidectomy without imaging.
Methods:
A prospective database of 2057 surgical patients with primary hyperparathyroidism from 2001 to 2019 was reviewed. Patients were categorized by use of preoperative imaging (ultrasound, sestamibi, CT scan), pathology, and cure.
Results:
1879 (91%) patients underwent preoperative imaging. CT scan was the most sensitive study (92%), though specificity was only 64%. Patients with imaging were older, had higher pre- and postoperative calcium, more likely to undergo unilateral exploration and have an adenoma (p < 0.001-0.038). No differences were seen in nerve injury (<1%), postoperative hypocalcemia (<1%), or cure rate.
Conclusions:
While localization may lead to minimally-invasive operations, we observed no differences in postoperative complications or cure rates in the hands of an experienced surgeon. Therefore, preoperative parathyroid localization does not improve outcomes for hyperparathyroidism and can be ordered sparingly.
