Inappropriate requesting of parathyroid scintigraphy at an academic medical center

Brad Kimura, Jodi Nagelberg, Sonya J. Koo, Julie Bykowski, Kevin T. Brumund, Karen C. McCowen

Research output: Contribution to journalArticlepeer-review


Background: Primary hyperparathyroidism is a biochemical, not radiologic diagnosis. Parathyroid scintigraphy should only be requested for surgical planning, not to confirm diagnosis. Here we determined reasons for inappropriately ordered parathyroid scintigraphy. Methods: We generated a database of patients undergoing parathyroid scintigraphy over 5 years, who did not undergo parathyroidectomy. Results: Over 5 years 129 parathyroid scintigraphies (of 308 total scans) were performed in patients who did not undergo parathyroidectomy. We determined that only 58 (45%) had true primary hyperparathyroidism. The most common reason for the scan was to “confirm the diagnosis.” Only 20% were ordered for adenoma localization, although surgery was not performed. Physicians requesting parathyroid scintigraphies specialized in a variety of disciplines. Conclusion: Forty-two percent of parathyroid scintigraphies were requested inappropriately to “confirm” a diagnosis of primary hyperparathyroidism. We propose to change the ordering system to clarify that parathyroid scintigraphy is a functional tool to optimize surgery when the diagnosis is secure.

Original languageEnglish (US)
Pages (from-to)3404-3407
Number of pages4
JournalHead and Neck
Issue number11
StatePublished - Nov 2021
Externally publishedYes


  • parathyroid adenoma
  • preoperative localization
  • primary hyperparathyroidism
  • scintigraphy
  • secondary hyperparathyroidism

ASJC Scopus subject areas

  • Otorhinolaryngology


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