{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T08:32:10Z","timestamp":1774686730596,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2007,10,10]],"date-time":"2007-10-10T00:00:00Z","timestamp":1191974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,11,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The detection of parathyroid adenomas by 99mTc-labelled hexakis 2-methoxyisobutyl isonitrile (sestamibi) scintigraphy is influenced by several factors, including tumour size and serum level of parathyroid hormone (PTH). This study examined the relationship between sestamibi accumulation and multidrug resistance (MDR)-related P-glycoprotein (P-gp) expression in a large series of surgically excised parathyroid tumours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy-eight patients underwent dual-phase sestamibi imaging before parathyroidectomy. Expression of P-gp within tumour cells was assessed by immunohistochemistry. Tumour size was measured and the ellipsoid volume calculated. Scan results were analysed in relation to preoperative serum levels of calcium and PTH, P-gp expression and tumour volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty-four of the 78 sestamibi scans were positive and 14 negative. Smaller adenomas (less than 0\u00b75 cm3) were more likely to be sestamibi negative than larger lesions (P = 0\u00b7006). Ten of 14 adenomas with negative imaging showed strong P-gp membrane positivity and 45 of 64 lesions with a positive scan did not show P-gp membrane expression, indicating a significant association between high P-gp membrane immunoreactivity and negative sestamibi result (P = 0\u00b7006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data suggest an association between P-gp membrane expression and false-negative sestamibi scan result. Inhibition of the P-gp transmembrane pump using MDR modulators may therefore improve the sensitivity of sestamibi scintigraphy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.5882","type":"journal-article","created":{"date-parts":[[2007,10,10]],"date-time":"2007-10-10T13:46:27Z","timestamp":1192023987000},"page":"1491-1495","source":"Crossref","is-referenced-by-count":27,"title":["P-glycoprotein expression is associated with sestamibi washout in primary hyperparathyroidism"],"prefix":"10.1093","volume":"94","author":[{"given":"Y","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Happerfield","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S E","family":"Pinder","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K K","family":"Balan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G C","family":"Wishart","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Addenbrooke's Hospital, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2007,10,10]]},"reference":[{"key":"2021070907402027600_bib1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/bjs.4463","article-title":"Focused parathyroid surgery with intraoperative parathyroid hormone measurement as a day-case procedure","volume":"91","author":"Gurnell","year":"2004","journal-title":"Br J Surg"},{"key":"2021070907402027600_bib2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/00006231-200302000-00004","article-title":"Parathyroid imaging: preoperative localization","volume":"24","author":"O'Doherty","year":"2003","journal-title":"Nucl Med Commun"},{"key":"2021070907402027600_bib3","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1001\/archsurg.139.5.501","article-title":"An algorithm to maximise use of minimally invasive parathyroidectomy","volume":"139","author":"Quiros","year":"2004","journal-title":"Arch Surg"},{"key":"2021070907402027600_bib4","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/00000658-200009000-00005","article-title":"One hundred consecutive minimally invasive parathyroid explorations","volume":"232","author":"Udelsman","year":"2000","journal-title":"Ann Surg"},{"key":"2021070907402027600_bib5","first-page":"346","article-title":"The accuracy of parathyroid gland localization in primary hyperparathyroidism using sestamibi radionuclide imaging","volume":"81","author":"Johnston","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2021070907402027600_bib6","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1001\/archotol.1996.01890160011002","article-title":"Preoperative technetium Tc 99m sestamibi imaging. 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