Parathyroid imaging is performed in the setting of primary hyperparathyroidism with intent to localize adenomatous parathyroid tissue before minimally invasive surgery. Available imaging options currently consist of ultrasound, radionuclide scanning, magnetic resonance imaging, and both conventional and "4 D" computed tomography. Various combinations of these modalities are used based primarily on institutional bias, and although highly successful in localizing the common single adenoma, they are less effective when there is multiglandular disease or glandular ectopia.
