title: 4D MRI for the Localization of Parathyroid Adenoma: A Novel Method in Evolution.
abstract: The sestamibi scan (MIBI) and ultrasound (US) are used for preoperative localization of parathyroid adenoma (PTA), with sensitivity as high as 90%. We developed 4-dimensional magnetic resonance imaging (4D MRI) as a novel tool for identifying PTAs. Eleven patients with PTA were enrolled. 4D MRI from the mandible to the aortic arch was used. Optimization of the timing of image acquisition was obtained by changing dynamic and static sequences. PTAs were identified in all except 1 patient. In 9 patients, there was a complete match between the 4D MRI and the US and MIBI, as well as with the operative finding. In 1 patient, the adenoma was correctly localized by 4D MRI, in contrast to the US and MIBI scan. The sensitivity of the 4D MRI was 90% and after optimization, 100%. Specificity was 100%. We concluded that 4D MRI is a reliable technique for identification of PTAs, although more studies are needed.
authors.affiliation: ARM Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel Merchavy@gmail.com.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Merchavy
authors.affiliation: Imaging Department, Assuta Medical Center, Tel Aviv, Israel.
authors.forename: Judith
authors.initials: J
authors.lastname: Luckman
authors.affiliation: Imaging Department, Assuta Medical Center, Tel Aviv, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Guindy
authors.affiliation: Imaging Department, Assuta Medical Center, Tel Aviv, Israel.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Segev
authors.affiliation: ARM Center of Otolaryngology Head and Neck Surgery, Assuta Medical Center, Tel Aviv, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Khafif
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D003287:Contrast Media; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C090600:gadobutrol; D008536:Meglumine; D017256:Technetium Tc 99m Sestamibi; C072417:gadoterate meglumine
keywords: 4D MRI; Sestamibi scan; minimally invasive surgery; parathyroid adenoma; ultrasound