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Related Experiment Video

Updated: Nov 4, 2025

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Parathyroid Imaging Practices for Primary Hyperparathyroidism Without Previous Operations Among Endocrine Surgery

Ruth Obiarinze1, Herbert Chen1, Brenessa Lindeman1

  • 1Department of Surgery, Division of Breast and Endocrine Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

The American Surgeon
|May 31, 2021
PubMed
Summary

Preoperative imaging for primary hyperparathyroidism (pHPT) shows significant variability, even within surgical practices. Clinical support teams often recommend different imaging tests than endocrine surgeons, indicating a need for improved institutional protocols.

Keywords:
imagingparathyroidpreoperative imagingprimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism (pHPT) utilizes various imaging modalities.
  • Surgeon-specific study utilization and variable opinions in parathyroid surgery contribute to management heterogeneity.
  • Increasing pHPT diagnoses highlight the need to understand current imaging practices.

Purpose of the Study:

  • To investigate the preoperative parathyroid imaging practices among endocrine surgeons.
  • To identify variations in imaging test choices within individual surgical practices.
  • To assess the influence of clinical support teams on imaging recommendations.

Main Methods:

  • An email-based survey was sent to program directors of 22 American Association of Endocrine Surgeons fellowship programs.
  • The survey queried the initial diagnostic test of choice for pHPT.
  • Clinical support team members were contacted to compare their recommendations with those of their institution's endocrine surgeons.

Main Results:

  • 68% of clinical team members recommended different or additional imaging tests compared to their institution's endocrine surgeon.
  • Neck ultrasound was the most common initial imaging test repeated by both surgeons and clinical team members.
  • 33% of clinical team members agreed with their surgeon's initial ultrasound recommendation.

Conclusions:

  • Significant variability exists in preoperative imaging for hyperparathyroidism.
  • Inconsistency in imaging recommendations extends within individual surgical practices due to clinical support team influence.
  • Improved clinical protocols are needed to standardize preoperative imaging within institutions.