You may have been told by your doctor that you need to have a test done on your parathyroid glands. It's normal to feel a little scared and curious when you hear that. So today, let's talk about this parathyroid scan in a simple way that you can understand. This is actually a special test that looks at the parathyroid glands inside your body.
What is a Parathyroid Scan?
Simply put, a parathyroid scan is a very safe, painless imaging procedure. It allows our healthcare providers, doctors, to determine if one or more of our parathyroid glands are underactive or overactive. It’s like looking at these tiny glands in our necks with a tiny camera. This scan is usually done as an ultrasound or a nuclear scan.
Why do we need to do a Parathyroid Scan?
The main reason your doctor might order this scan is if your blood tests show that you have a condition called hyperparathyroidism. Hyperparathyroidism is simply a condition where your blood has too much calcium. So, if your doctor thinks the best treatment for this is to remove the overactive gland or glands, then this scan is very important.
Imagine, the surgeon needs to know exactly which gland or glands to remove and where they are. That's what the images from this scan help with. This allows the surgery to be done with a very small incision, that is, with minimal damage (minimally invasive) . However, this is not always necessary for diagnosis or surgical planning.
Another reason is that sometimes our parathyroid glands can be located in an unusual place, not where they should normally be. We call them ``Ectopic Glands''. In such cases, this scan is used to find the exact location of those glands.
What are the types of parathyroid scans?
There are several types of parathyroid scans. You and your doctor can discuss which method is best for you.
The two main types that are often used are:
1. Ultrasound scan
2. Nuclear Scan (also called Sestamibi Scan or MIBI)
Sometimes, doctors use both types of scans to get the clearest picture of the gland (or glands) that is most active.
Ultrasound Parathyroid Scan
Ultrasound is a very safe medical imaging test. It uses sound waves to make real-time pictures or videos of organs, blood vessels, and glands inside our bodies. This allows doctors to see even the smallest details clearly without making any cuts or incisions .
Nuclear Parathyroid Scan
There are several types of nuclear parathyroid scans, and the procedures involved are slightly different. But in general, this scan involves your doctor injecting a safe, radioactive liquid (radiotracer) into your vein. Don't worry, this liquid is very safe. This radioactive liquid travels through your bloodstream and is absorbed by your parathyroid glands.
Then, a special camera takes pictures of your parathyroid glands. The overactive parathyroid gland or glands will appear larger and brighter in the picture. In most nuclear parathyroid scans, the pictures are taken several times. The doctor can then compare the pictures with each other.
There are several types of Nuclear Parathyroid Scan:
- Single-phase dual-isotope subtraction imaging: In this, two types of radioactive substances (radiotracers) (for example, sestamibi and pertechnetate) are injected into your vein at different times. Pictures are taken with a special camera after each injection.
- Single-isotope dual-phase imaging: In this scan, a single radioactive substance (sestamibi) is injected into a vein. Then, images are taken 10-15 minutes after the injection, and again 90 minutes to three hours later.
In addition, sometimes doctors may use other imaging techniques, such as an MRI or PET scan, for this parathyroid scan. Your medical team will decide which option is best for you.
How do we prepare for this scan?
Your doctor will tell you if there are any special instructions you need to follow before the scan. For example, whether or not you can eat or drink before the scan.
You will often need to remove your jewelry and other items of clothing before the scan, as these items can interfere with the imaging process.
The most important thing is that if you are going for a nuclear scan, you must definitely tell your doctor if you are pregnant, or if you have even the slightest suspicion that you are pregnant, and if you are a breastfeeding mother. This is very important, don't forget.
What happens during the scan? What should we expect?
What happens at that time depends on the type of parathyroid scan you have.
How to do an ultrasound scan
If you are having an ultrasound scan, you will usually be placed face up on an examination table with something like a pillow under your neck.
Then the ultrasound technician will do these things:
- A gel is applied: A small amount of gel is applied to the skin of your neck. This gel will not harm your skin, and even if it gets on your clothes, it can be washed off.
- Using an ultrasound probe/transducer: Next, a handheld device that looks like a microphone is moved back and forth over the gel. This is how "pictures" of your parathyroid glands are taken.
- You will be asked to remain still: It is easier to take clear pictures when you remain as still as possible.
- Cleanses your skin: Finally, any remaining gel on your neck is wiped away.
How a Nuclear Scan is Performed
Since there are several types of Nuclear Parathyroid Scans, your doctor will explain exactly what is going to happen to you. Don't be afraid to ask them anything.
In general, a nuclear scan involves injecting a safe radioactive liquid (radiotracer) into your vein. The liquid is safe, but you may feel a slight stinging sensation when the needle is inserted.
Then, you will lie face up on an examination table, and an imaging machine will be used to take pictures of your parathyroid glands.
You should not experience any side effects after this Nuclear Parathyroid Scan. You will be able to drive yourself home after the test is over.
How long does this scan usually take?
- An ultrasound scan usually takes about 30 minutes to an hour .
- The entire Nuclear Parathyroid Scan process can take between two and five hours , depending on the type.
When can we expect the scan results?
Depending on the type of parathyroid scan you had, a radiologist or other specialist will look at and interpret the images. They will then send a report to your doctor and surgeon. Your medical team will then make an appointment with you to discuss the results. This can take anywhere from a few days to a week .
What is an "Abnormal Test Result"?
A parathyroid scan shows which gland (or glands) your surgeon needs to remove.
- An abnormal result of a nuclear parathyroid scan is what is called a "hot spot." That is, areas that absorb the radioactive substance (radiotracer) quickly and appear very bright. That is what tells the surgeon that the gland needs to be removed.
- The results of an ultrasound scan may be abnormal if one of your parathyroid glands appears enlarged, meaning swollen.
Finally, a few things to remember (Take-Home Message)
A parathyroid scan is a very safe and useful tool that helps your surgeon plan for surgical removal of an overactive parathyroid gland or glands.
Once you know exactly where the overactive gland or glands are, the surgery can be done with a small incision, meaning minimally invasive . So, if you have to have a scan like this, make sure it's done in a place that knows how to do it accurately, safely, and with experience. Don't be afraid of anything, talk to your doctor about everything, and ask any questions you have.
` Parathyroid Scan, Hyperparathyroidism, Ultrasound, Nuclear Scan, Surgery
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