Leaderboard Ad

Advancements in Parathyroid Imaging

Preoperative imaging can facilitate localization of hyperfunctional parathyroid glands, and thus improve outcomes for patients undergoing surgery for hyperparathyroidism. Insurance companies are increasingly scrutinizing preoperative imaging in parathyroid surgery; therefore, it is critical that otolaryngologists remain intimately familiar with the indications, advantages, and limitations of preoperative imaging studies. 

Mark E. Zafereo, Jr., MD

“In this session, we are fortunate to have a panel of national experts who will discuss the rapidly changing landscape of parathyroid imaging and intraoperative parathyroid localization in 2018,” said session moderator Mark E. Zafereo, Jr., MD. “It is essential for otolaryngologists to have a thorough understanding of preoperative and intraoperative techniques for parathyroid localization in order to provide optimal parathyroid surgical care for their patients.”

The session was created based on the extensive efforts of the Endocrine and Imaging Committees of the AAO-HNSF, which worked with Anthem to revise its insurance policy in relation to preoperative localization imaging in parathyroid surgery.

Parathyroid Imaging 2018

Today, 10:00 – 11:00 am

GWCC, Building B, Room 313

“Thanks to the efforts of experts from these committees and the hard work of Academy staff, our physicians can now spend less time negotiating with insurance companies on the medical necessity of a SPECT/CT, and more time in caring for our patients,” Dr. Zafereo said. 

In working through the AAO-HNS/F committee structure in this effort, he said they realized how many of their colleagues were struggling with insurance approval for preoperative localization imaging in parathyroid surgery. He said their discussions underscored the importance of otolaryngologists staying abreast of new technologies in parathyroid localization so that they can continue to provide the best care for patients.

“Parathyroid surgery is a key component of otolaryngology practice,” Dr. Zafereo said. “Surgery to correct hyperparathyroidism can have profound impact on patient quality of life and lifespan. The most important aspect of parathyroid surgery is the preoperative and intraoperative localization of abnormal parathyroid gland(s). We owe it to our patients to stay up-to-date on this rapidly changing scene of preoperative imaging and intraoperative localization in parathyroid surgery.”

In the session, Dr. Zafereo will introduce the most current guidelines in diagnostics in primary hyperparathyroidism and surgical indications for parathyroid surgery. Maisie L. Shindo, MD, a national expert in parathyroid ultrasound, will discuss pearls for ultrasound identification of parathyroid glands. Russell B. Smith, MD, another national expert in parathyroid pathology, will review imaging localization for abnormal parathyroid glands beyond ultrasound, including CT, MRI, Sestamibi scans, and SPECT/CT. Finally, Michael. C. Singer, MD, will tie in preoperative imaging localization with intraoperative localization techniques including PTH assays, venous sampling, autofluorescence, and intraoperative gamma probe.

“I hope many colleagues will attend this important discussion of advancements in parathyroid imaging,” Dr. Zafereo said. “Anyone who regularly performs parathyroid surgery has experienced the frustrations of intraoperative exploration in difficult parathyroid cases, as well as insurance denials related to preoperative localization imaging. It is essential for otolaryngologists who do parathyroid surgery to be facile with the most up-to-date techniques in parathyroid localization in order to maximize their surgical success and minimize surgical misses and recurrences.”

Dr. Zafereo also noted the AAO-HNS Position Statement on the subject.