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. 2016 Mar 1;32(1):58–66. doi: 10.5152/UCD.2015.3032

Table 2.

Localization imaging studies

Image name and type Sensitivity (%) Specificity (%) Advantages Disadvantages
Tc Sestamibi Functional 75–90 75–98

  • - Standard preoperative localizing test

  • - Minimal radiation

  • - For radioguided parathyroidectomy

  • - Excellent anatomical localization if combined with SPECT

  • - Limited sensitivity in multiglandular diseases

  • - Takes a long time for the patient (2–4 hours), inconvenient

  • - Cannot reliably distinguish thyroid nodule from parathyroid glands
US Anatomical 70–80 80–89

  • - Cheap, non-invasive, quick, portable

  • - No radiation or IV contrast

  • - Can be done preoperatively and intraoperatively

  • - Operator dependent

  • - Poor sensitivity in detecting substernal, retroesophageal and retrotracheal parathyroid glands

  • - Cannot detect small lesions <5mm
CT/4D CT
Anatomical/ Functional 50–80 80–98

  • - More sensitive than ultrasound for smaller lesions

  • - Allows for visualization of mediastinum

  • - Radiation exposure and risks of IV contrast

  • - Cannot differentiate parathyroid tissue from other types of tissue like lymph nodes
MRI
Anatomical 65–80 88–95

  • - Avoids radiation and IV contrast

  • - Limited availability

  • - Limited use due to claustrophobia

Tc Sestamibi: technetium sestamibi; SPECT: single-photon emission computerized tomography; US: ultrasound; IV: intravenous; CT: computerized tomography; 4D CT: 4 dimensions computerized tomography; MRI: magnetic resonance imaging