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This booklet is predicated at the authors’ large functional adventure within the use of recent radiological easy methods to diagnose parathyroid illnesses and the applying of complex surgical ideas. specific realization is dedicated to the embryological history to stress the importance of diagnostic and surgical peculiarities. Pre- and intraoperative imaging is mentioned intensive, with a different specialise in localizing suggestions. Ultrasound-guided minimally invasive innovations, together with percutaneous laser ablation, are absolutely thought of. This up to date and richly illustrated booklet will curiosity and help experts in ultrasound diagnostics, radiologists, endocrinologists, and surgeons.
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This publication is predicated at the authors’ huge sensible event within the use of recent radiological how to diagnose parathyroid ailments and the appliance of complicated surgical innovations. designated realization is dedicated to the embryological historical past to stress the importance of diagnostic and surgical peculiarities.
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Additional info for The Parathyroid Glands: Imaging and Surgery
Positron radionuclides are short-lived and ultrashort-lived isotopes. Accelerators producing positron radiopharmaceuticals and laboratories in which the labels for radiopharmaceuticals are prepared are normally located not far from PET departments. However, if separate PET cameras can be established, radiopharmaceuticals are delivered from other centers in these cases. The volume of clinical investigations in each center directly depends on the availability of the required radiopharmaceutical. To obtain images of the parathyroid glands in PHPT patients, short-lived 11C-aamino-g-methylthiobutyric acid (T1/2 = 20 min) 18 F-fluorine-deoxyglucose (18F-FDG; and T1/2 = 109 min) are used, as these are highly sensitive and specific to parathyroid adenomas.
Some authors explain the lesser efficacy of scintigraphy in SHPT by that fact that the mass of hyperplastic parathyroid glands is usually less than that of an adenoma. Growth of the number of oxyphil parathyroid cells by 20 % increases the possibility of positive results fourfold. Erbil et al. (2008a, b) studied the morphologic features of adenomas of different masses. They came to the conclusion that a large size of adenoma in patients undergoing scintigraphy with 99mTc-sestamibi plays a greater role in obtaining positive results than their anatomic features, which are less significant.
There are several radionuclides facilitating its imaging: predominantly isotopes of iodine (131I-natrium iodide and 123I-natrium iodide) and technetium (99mTc-pertechnetate). The history of using isotopic methods for the diagnosis of thyroid diseases began with the application of 131I. Owing to its structure, 131I passes through all steps of iodine metabolism, including organification. But now 131I is used predominantly for the diagnosis of metastases and relapses of thyroid cancer owing to its long half-life (8 days) and large radiation load.