{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:18:00Z","timestamp":1779916680425,"version":"3.53.1"},"reference-count":80,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Parathyroid carcinoma (PC) is an exceedingly rare endocrine malignancy, accounting for less than 1% of all primary hyperparathyroidism (pHPT) cases. It typically presents with pronounced hypercalcemia and markedly elevated parathyroid hormone (PTH) levels. Accurate imaging plays a pivotal role in diagnosis, staging, surgical planning, and long-term surveillance, although differentiating PC from benign disease on imaging remains a significant challenge. A multimodal imaging strategy combining cervical ultrasonography (US) and nuclear medicine techniques provides high sensitivity for lesion detection. Ultrasonography with advanced detective flow imaging allows detailed anatomical assessment and evaluation of vascular patterns of the primary tumor. [99mTc]Tc-methoxyisobutylisonitrile ([99mTc]Tc-MIBI) scintigraphy frequently demonstrates prolonged tracer retention in PC, while [18F]fluorocholine positron emission tomography\/computed tomography (PET\/CT) and positron emission tomography\/magnetic resonance (PET\/MR) imaging have shown superior performance for detecting both primary tumors and metastatic disease due to its higher spatial resolution and higher molecular sensitivity. [18F]FDG PET serves as an adjunct modality for identifying aggressive, metabolically active lesions. Emerging radiotracers such as [18F]-fibroblast activation protein inhibitor ([18F]FAPI) and [68Ga]Ga-trivehexin have shown potential in cases where initial imaging is inconclusive. Theranostic strategies that integrate molecular imaging with targeted radioligand therapy may transform PC management by enabling personalized treatment approaches tailored to each tumor\u2019s biological and imaging characteristics. This review aims to evaluate available imaging modalities for PC diagnosis and provide guidance for their clinical application.<\/jats:p>","DOI":"10.3390\/life15121861","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T13:53:30Z","timestamp":1764856410000},"page":"1861","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular Imaging in Parathyroid Carcinoma Management: A Comprehensive Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1946-2128","authenticated-orcid":false,"given":"Petra","family":"Petranovi\u0107 Ov\u010dari\u010dek","sequence":"first","affiliation":[{"name":"Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0230-0974","authenticated-orcid":false,"given":"Luca","family":"Giovanella","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Thyroid Center, Gruppo Ospedaliero Moncucco, Via Soldino 5, 6900 Lugano, Switzerland"},{"name":"Department of Nuclear Medicine, University Hospital of Zurich, R\u00e4mistrasse 100, 8091 Zurich, Switzerland"},{"name":"Department of Nuclear Medicine, University of Zurich, Pestalozzistrasse 3, 8032 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2352-3587","authenticated-orcid":false,"given":"Murat","family":"Tuncel","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Hacettepe University, 06230 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junko Inoue","family":"Inukai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-6965","authenticated-orcid":false,"given":"Virginia","family":"Liberini","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Azienda Ospedaliera S Croce e Carle Cuneo, Via Michele Coppino 26, 12100 Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5221-1634","authenticated-orcid":false,"given":"Matija","family":"Romi\u0107","sequence":"additional","affiliation":[{"name":"Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9sir\u00e9e","family":"Deandreis","sequence":"additional","affiliation":[{"name":"Institute Gustave Roussy, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-684X","authenticated-orcid":false,"given":"Rosaria Maddalena","family":"Ruggeri","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6023-5055","authenticated-orcid":false,"given":"Flaminia","family":"Vocaturo","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences and Haematology, Section of Nuclear Medicine, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0177-939X","authenticated-orcid":false,"given":"Alfredo","family":"Campenn\u00ec","sequence":"additional","affiliation":[{"name":"Unit of Nuclear Medicine, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98100 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-3292","authenticated-orcid":false,"given":"Martin W.","family":"Huellner","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, University Hospital of Zurich, R\u00e4mistrasse 100, 8091 Zurich, Switzerland"},{"name":"Department of Nuclear Medicine, University of Zurich, Pestalozzistrasse 3, 8032 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/BF02819737","article-title":"Parastruma Maligna Aberrata","volume":"100","year":"1909","journal-title":"Dtsch. 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