Becker JL, Patel V, Johnson KJ, et al. - This study was intended to investigate the hypothesis that our recently introduced 4D–dynamic contrast-enhanced MR imaging with high spatial and temporal resolution has equivalent accuracy to 4D-CT for preoperative gland localization in primary hyperparathyroidism without requiring exposure to ionizing radiation. Confirmed biochemical diagnosis of primary hyperparathyroidism, 2) preoperative 4D–dynamic contrast-enhanced MR imaging, and 3) surgical cure with >50% decrease in serum parathyroid hormone intraoperatively were the inclusion criteria. Researchers included a total of 54 individuals: 37 had single-gland disease, and 17, multigland disease (9 with double-gland hyperplasia; 3 with 3-gland hyperplasia; and 5 with 4-gland hyperplasia). Two neuroradiologists independently examined 4D–dynamic contrast-enhanced studies to distinguish the side, quadrant, and number of abnormal glands, and compared with surgical and pathologic outcomes. The results of this study indicated that proposed high spatial and temporal resolution 4D–dynamic contrast-enhanced MR imaging gives excellent diagnostic performance for preoperative localization in primary hyperparathyroidism, with correct gland localization of 92% for single-gland disease and 74% in multigland disease, superior to 4D-CT studies.