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Imaging

The most common parathyroid imaging studies include sestamibi scan (a nuclear medicine study), ultrasound, and CT scan.

Can I have surgery with a negative scan? I was diagnosed with primary hyperparathyroidism last year, but no one can seem to find a parathyroid tumor. I have had two sestamibi scans, a CT, and ultrasound but they were all negative. My surgeon says he will not operate until something is seen on the scan. I am having bad bone pain and want to get this done. How can we find this parathyroid?

Imaging studies should not be used to determine when to operate. We diagnose parathyroid disease with labs, not with imaging, so we know that you have at least one diseased parathyroid gland. If the diagnosis is clear, then there is no reason to wait to have surgery, as long as you have an experienced surgeon who can evaluate all four parathyroid glands. If you have a surgeon who wants to see t...

Operation Imaging Operative technique

I have been diagnosed with Primary Hyperparathyroidism and Osteoporosis. I had a 4D CT on the parathyroids and it was normal. Do you think a Sestamibi scan or another test will be better for diagnose or should I wait until my next blood check to see if my Vitamin D3 helped. My endocrinologist said I don't need to take calcium supplements and just keep taking the vitamin K and my ENT doctor said I'm not a good candidate for surgery based on the 4D CT results. I will have the surgery If I can get better. What do you think about my tests levels? My calcium is 9.1 mg/dl and PTH 91 pg/ml. Based on your Analysis Tool I have Secondary Hyperparathyroidism not Primary. Can you please help me?

There are really two separate questions here: 1. What do I do if the 4D CT scan does not show a parathyroid tumor? 2. Is this primary hyperparathyroidism or secondary? For the first question: 4D CTs, or any other scan used to find parathyroid tumors, are not used to diagnose parathyroid disease or determine whether you need surgery. We use lab results to diagnose primary hyperparathyroidi...

Diagnosis Imaging

My blood report reads: Calcium 10.4, PTH 85.3, Vitamin D is 58.5, Albumin 5, Calcium Ionized 5.19. I am 58 years old. I have stopped taking 5000mg of Vitamin D, tho my doctor said I should have an MRI to see which thyroid needs to be removed. Does this make sense? Thank you very much.

Thanks for writing. Your blood tests indicate that you have primary hyperparathyroidism. You have a calcium level that is high for your age, with a high PTH. Most of the time, primary hyperparathyroidism is caused by a benign parathyroid tumor, or adenoma. The treatment for this is removal of the parathyroid tumor. Sometimes, imaging can show which parathyroid gland is diseased. Your doctor...

Diagnosis Imaging Hypercalcemia primary hyperparathyroidism

I had a recent CT scan of parathyroid that was reported normal. I was put on low calcium diet for next 2 months then repeat tests. Can CTs be false negative & can diet change results and help confirm need for surgery or is it a waste of time? Seems surgery is needed now? Thank you from Ontario, Canada. Calcium is 2.83 mmol/L (11.3 mg/dl) and PTH 14.2 pmol/L (134 pg/ml). I am 68 years old.

First, these labs very clearly indicate primary hyperparathyroidism, since the calcium and PTH are both far outside normal range. We don't need anything else to make the diagnosis. A low calcium diet is not going to change this diagnosis. Your calcium and PTH levels may both fluctuate to some extent, since that happens with primary hyperparathyroidism, but the diagnosis will not change. ...

Diagnosis Hypercalcemia Primary HPT Parathyroid Disease Basics Imaging

I have both high pth (140) and high calcium (10.4). A Scan of my parathyroid glands showed normal. What should I do to lower these?

Thanks for writing. Your scenario is fairly common. Your labs are classic for primary hyperparathyroidism (high calcium and high PTH), but your parathyroid scans are negative (no parathyroid tumors seen). So what should you do to lower the calcium and PTH? **Short answer: A parathyroid operation.** Long answer: Parathyroid surgery is the only way to cure primary hyperparathyroidism. ...

primary hyperparathyroidism Diagnosis Treatment Parathyroid Disease Basics Imaging