Name of the Procedure:

Parathyroid Planar Imaging (including Subtraction, when performed)

Summary

Parathyroid planar imaging is a specialized nuclear medicine procedure used to visualize the parathyroid glands. It involves injecting a small amount of radioactive material and taking images to detect overactive glands. The subtraction technique helps differentiate parathyroid tissue from other tissues.

Purpose

Parathyroid planar imaging is primarily used to diagnose and localize overactive parathyroid glands, which are often responsible for conditions like hyperparathyroidism. The goal is to identify the exact location of abnormal parathyroid tissue to guide potential surgical removal or other treatments.

Indications

• Symptoms of hyperparathyroidism such as fatigue, muscle weakness, and kidney stones.
• Biochemical evidence of elevated parathyroid hormone (PTH) levels.
• High calcium levels in the blood.
• Pre-surgical localization of parathyroid adenomas.

Preparation

• Inform your doctor of all medications and supplements you are taking.
• You may be instructed to avoid eating or drinking for several hours before the procedure.
• Blood tests may be required to assess calcium and PTH levels prior to imaging.

Procedure Description

1. You will receive an intravenous injection of a small amount of a radioactive tracer.
2. After the injection, you will wait for a period (usually 15 minutes to a few hours) to allow the tracer to concentrate in the parathyroid tissue.
3. You will lie on a scanning table while a gamma camera captures images of your neck and chest area.
4. Subtraction imaging may be performed by taking two sets of images and using software to subtract one set from the other, highlighting abnormal parathyroid tissue.
5. The entire process involves minimal movement and you will need to remain still during image capture.

Duration

The entire procedure typically takes about 1-2 hours, including waiting time for the tracer to concentrate.

Setting

Parathyroid planar imaging is usually performed in the nuclear medicine department of a hospital or outpatient imaging center.

Personnel

• Nuclear medicine technologist
• Radiologist or nuclear medicine physician
• Nursing staff for patient preparation and support

Risks and Complications

• Minor discomfort at the injection site
• Rare allergic reaction to the radioactive tracer
• Minimal exposure to radiation, generally considered safe

Benefits

• Precise localization of abnormal parathyroid glands.
• Non-invasive procedure with minimal discomfort.
• Helps plan minimally invasive surgical procedures.

Recovery

• You can usually resume normal activities immediately after the procedure.
• Drink plenty of fluids to help flush the radioactive tracer from your body.
• Follow any additional instructions provided by your healthcare provider.

Alternatives

• Ultrasound imaging: Non-radioactive alternative but may not be as sensitive.
• Sestamibi scan combined with single-photon emission computed tomography (SPECT): Provides 3D imaging.
• Computed tomography (CT) or magnetic resonance imaging (MRI) as complementary tools but with different strengths and limitations.

Patient Experience

• You will feel a small pinch during the tracer injection.
• The imaging process is painless, though lying still may cause mild discomfort for some patients.
• Any pain or discomfort is usually minimal and short-lived.