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. 2019 Mar 5;291(2):469–476. doi: 10.1148/radiol.2019182122

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2019 by the Radiological Society of North America, Inc.

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Figure 4c: — Images in a 63-year-old woman with primary hyperparathyroidism. Superior localization of four-dimensional (4D) CT compared with sestamibi SPECT/CT in a patient with single-gland disease. (a) Axial contrast-enhanced arterial phase of parathyroid 4D CT shows a single abnormal left upper parathyroid adenoma (arrow). (b) Axial delayed-phase SPECT/CT and (c) axial delayed-phase SPECT-only images show persistent mild diffuse sestamibi uptake in the thyroid gland, but no focal uptake corresponding with left upper parathyroid adenoma identified at 4D CT. The patient underwent minimally invasive parathyroidectomy for a single left upper parathyroid adenoma and experienced an appropriate drop in intraoperative parathyroid hormone.