ACR Appropriateness Criteria® Parathyroid Adenoma.

Journal Article

Hyperparathyroidism is defined as excessive parathyroid hormone production. The diagnosis is made through biochemical testing, in which imaging has no role. However, imaging is appropriate for preoperative parathyroid gland localization with the intent of surgical cure. Imaging is particularly useful in the setting of primary hyperparathyroidism whereby accurate localization of a single parathyroid adenoma can facilitate minimally invasive parathyroidectomy. Imaging can also be useful to localize ectopic or supernumerary parathyroid glands and detail anatomy, which may impact surgery. This document summarizes the literature and provides imaging recommendations for hyperparathyroidism including primary hyperparathyroidism, recurrent or persistent primary hyperparathyroidism after parathyroid surgery, secondary hyperparathyroidism, and tertiary hyperparathyroidism. Recommendations include ultrasound, CT neck without and with contrast, and nuclear medicine parathyroid scans. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Full Text

Duke Authors

Cited Authors

  • Expert Panel on Neurological Imaging, ; Zander, D; Bunch, PM; Policeni, B; Juliano, AF; Carneiro-Pla, D; Dubey, P; Gule-Monroe, MK; Hagiwara, M; Hoang, JK; Jain, V; Kim, LT; Moonis, G; Parsons, MS; Rath, TJ; Solórzano, CC; Subramaniam, RM; Taheri, MR; DuChene Thoma, K; Trout, AT; Zafereo, ME; Corey, AS

Published Date

  • November 2021

Published In

Volume / Issue

  • 18 / 11S

Start / End Page

  • S406 - S422

PubMed ID

  • 34794597

Electronic International Standard Serial Number (EISSN)

  • 1558-349X

Digital Object Identifier (DOI)

  • 10.1016/j.jacr.2021.08.013


  • eng

Conference Location

  • United States