Structural and functional imaging of endocrine organs
Which scan for which gland and in what order, how to read thyroid scintigraphy, parathyroid sestamibi and 4D-CT, adrenal CT density, pituitary MRI and somatostatin receptor PET, and the traps of incidentalomas, iodine contrast and pregnancy.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Biochemistry first, imaging second. Incidental lesions are common: about 10% of pituitaries, 5% of adrenals on CT, and over half of thyroids on ultrasound. A scan without a biochemical diagnosis finds the wrong lesion.
- Structural imaging (ultrasound, CT, MRI) shows anatomy. Functional imaging (scintigraphy, PET) shows what the tissue does: trapping iodine, retaining sestamibi, expressing somatostatin receptors.
- Each gland has a default: ultrasound for thyroid and parathyroid, CT for adrenal, MRI for pituitary.
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Sources
- EANM practice guideline/SNMMI procedure standard for RAIU and thyroid scintigraphyEuropean Journal of Nuclear Medicine and Molecular Imaging (Giovanella L, et al.; 46:2514-25), 2019
- The EANM practice guidelines for parathyroid imagingEuropean Journal of Nuclear Medicine and Molecular Imaging (Petranović Ovčariček P, et al.; 48:2801-22), 2021 (no newer edition at November 2026)
- ACR Thyroid Imaging, Reporting and Data System (TI-RADS): white paper of the ACR TI-RADS CommitteeJournal of the American College of Radiology (Tessler FN, et al.; 14:587-95), 2017 (still current at November 2026)
- European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with ENSATEuropean Journal of Endocrinology (Fassnacht M, et al.), 2023
- Pheochromocytoma and paraganglioma: an Endocrine Society clinical practice guidelineJournal of Clinical Endocrinology and Metabolism (Lenders JW, et al.), 2014
- ENETS 2024 guidance paper for the management of well-differentiated small intestine neuroendocrine tumoursJournal of Neuroendocrinology (Lamarca A, et al.), 2024
- Iodinated contrast media guidelineAU/NZRoyal Australian and New Zealand College of Radiologists, V2.3, March 2018 (under review in 2026)
- Use of intravenous gadolinium-based contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney FoundationKidney Medicine (Weinreb JC, et al.), 2021
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback