INTERNATIONAL JOURNAL OF BIOMEDICINE REVIEW ARTICLE International Journal of Biomedicine 12(1) (2022) 82-88 http://dx.doi.org/10.21103/Article12(1)_RA3 The Ability of Contrast-Enhanced Ultrasound, Conventional Ultrasound, and 99m Tc-MIBI Scintigraphy for the Detection of Parathyroid Lesion in Patients with Primary Hyperparathyroidism Maryam M. Alramadhan 1 ; A. Alsolai 2 ; Rana A. Eisa 3* ; Awadia Gareeballah 4 1 King Saud Medical City, Riyadh, Saudi Arabia 2 Diagnostic Radiology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia 3 Health Sciences Department, Colleges of Applied Studies and Community Services, King Saud University, Riyadh, Saudi Arabia 4 Department of Diagnostic Radiologic Technology, Faculty of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia Abstract The aim of this review was to compare the effciency of conventional ultrasound (CUS), contrast-enhanced ultrasound (CEUS), and 99m Tc-MIBI scintigraphy in imaging parathyroid gland lesions in patients with primary hyperparathyroidism (PHPT). In this review, we attempted to present a clear view of the most reliable or precise technique for detecting parathyroid gland (PG) pathology in PHPT. Our study relied on secondary data based on the review of the extant literature on PHPT imaging. The research retrieved articles from the scholarly databases Google Scholar, Web of Science, and PUBMED/MEDLINE that examine the effciency of CUS, CEUS, and 99m Tc-MIBI scintigraphy in imaging PGs in PHPT patients. The study retrieved secondary data from past research identifed using keyword and medical subject heading terms like “Ultrasound,” “Contrast-Enhanced Ultrasound,” “Sonography in parathyroid,” “Primary hyperthyroidism,” “Scintigraphy,” and “Contrast-enhanced ultrasound in parathyroid disease.” This study only relied on original contribution papers presented in English and published between 2011 and 2021. We found that CEUS has a comparable sensitivity to 99m Tc-MIBI scintigraphy so that it can be used in patients who have a contraindication to scintigraphy or in a hospital without nuclear medicine facility. CEUS is able to detect very small size adenomas, whereas the detection using scintigraphy depends on the size of the diseased glands and the cytology.(International Journal of Biomedicine. 2022;12(1):82-88.) Key Words: contrast-enhanced ultrasound • conventional ultrasound • primary hyperparathyroidism • scintigraphy For citation: Alramadhan MM, Alsolai A, Eisa RA, Gareeballah A. The Ability of Contrast-Enhanced Ultrasound, Conventional Ultrasound, and 99mTc-MIBI Scintigraphy for the Detection of Parathyroid Lesion in Patients with Primary Hyperparathyroidism. International Journal of Biomedicine. 2022;12(1):82-88. doi:10.21103/Article12(1)_RA3 Abbreviations CEUS, contrast-enhanced ultrasound; CUS, conventional ultrasound; CT, computed tomography; PTA, parathyroid adenoma; PG, parathyroid gland; PHPT, primary hyperparathyroidism; SA, single adenoma; SPECT, singlephoton emission computed tomography. P rimary hyperparathyroidism (PHPT) is characterized by elevated serum calcium concentration and elevated or inappropriately normal parathyroid hormone levels. Silverberg describes the skeletal hallmark of PHPT as osteitis fbrosa cystica, radiographically characterized by brown tumors of the long bones, subperiosteal bone resorption, distal tapering of the clavicles, and phalanges, and “salt-and-pepper” erosions of the skull. Nephrocalcinosis and nephrolithiasis, as