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Invited Critique |

Locating Parathyroid Adenomas via Virtual Neck Exploration:  A Real-World Challenge for Surgeons
Comment on “Virtual Neck Exploration for Parathyroid Adenomas”

Peter Angelos, MD, PhD
JAMA Surg. 2013;148(3):238. doi:10.1001/jamasurg.2013.745.
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Despite recent advances in imaging and surgical methods, many patients with hyperparathyroidism continue to go to the operating room without their surgeons knowing where their abnormal parathyroid glands are located. In the article titled “Virtual neck exploration for parathyroid adenomas: a first step toward minimally invasive image-guided surgery,” D’Agostino and colleagues1 have provided a clear presentation of their use of multiple methods of enhanced 3-dimensional (3D) rendering to improve the ability to identify the location of parathyroid adenomas. Although the authors acknowledged that current 3D rendering techniques are time consuming and labor intensive, this study illustrates 2 important concepts. (1) The data gathered through conventional imaging techniques can be manipulated and reinterpreted to allow us to see things that we had not previously noticed. (2) Sometimes costly techniques must be fully explored to evaluate the potential benefits.

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[Maxillary tumor revealing primary hyperparathyroidism]. Rev Stomatol Chir Maxillofac Chir Orale 2014;115(5):323-6.
Primary and Metastatic Parathyroid Malignancies: A Rare or Underdiagnosed Condition? J Clin Endocrinol Metab Published online Dec 9, 2014.;
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