{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:53:03Z","timestamp":1790034783359,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2004,10,15]],"date-time":"2004-10-15T00:00:00Z","timestamp":1097798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2004,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The present study evaluated sestamibi scan\u2013directed parathyroidectomy with intraoperative parathyroid hormone (PTH) assessment (ioPTH). The preoperative sestamibi scintigraphies were compared with the intraoperative findings for 103 patients undergoing first exploration for sporadic primary hyperparathyroidism (pHPT). Data were collected prospectively. Ninety\u2010nine patients (96%) were cured. Patients with persistent pHPT (<jats:italic>n<\/jats:italic> = 4) all had an incorrect scintigram as well as an insufficient decline of ioPTH. At operation, 90 patients (87%) had solitary parathyroid adenoma; 12 patients had multiglandular disease. In one patient no enlarged parathyroid gland was found. Overall 77 of 118 abnormal glands (65%) were correctly identified by sestamibi scintigraphy. The sensitivity for localizing a single parathyroid adenoma was 80%. Patients with incorrect scintigrams had a higher proportion of upper pole adenomas than patients with correct scans. High glandular weight and high level of serum PTH were important factors for detectability. Sestamibi scintigraphy did not predict multiglandular disease. However, the use of ioPTH identified 8 of the 9 patients with a positive scan (a solitary focus) and multiglandular disease. In contrast, false\u2010negative ioPTH led to four unnecessary bilateral explorations in the 63 patients with a scan\u2010identified adenoma. With the help of ioPTH, a focused parathyroidectomy was accomplished in 43% of scan\u2010negative patients with a solitary adenoma. In conclusion, sestamibi scintigraphy is an acceptable method for localizing a solitary parathyroid adenoma. However, the technique alone does not reliably predict multiglandular disease. Potentially the failure rate in scan\u2010directed parathyroidectomy could increase, with up to 10% of patients without ioPTH.<\/jats:p>","DOI":"10.1007\/s00268-004-7484-3","type":"journal-article","created":{"date-parts":[[2004,10,14]],"date-time":"2004-10-14T21:23:41Z","timestamp":1097789021000},"page":"1132-1138","source":"Crossref","is-referenced-by-count":63,"title":["Sestamibi Scan\u2013directed Parathyroid Surgery: Potentially High Failure Rate without Measurement of Intraoperative Parathyroid Hormone"],"prefix":"10.1002","volume":"28","author":[{"given":"Johan","family":"Westerdahl","sequence":"first","affiliation":[{"name":"Department of Surgery Lund University Hospital S\u2010221 85 Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Bergenfelz","sequence":"additional","affiliation":[{"name":"Department of Surgery Lund University Hospital S\u2010221 85 Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,15]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01665301"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1998.tb126768.x"},{"key":"e_1_2_7_4_2","first-page":"103","article-title":"Current trends in the surgical treatment of solitary parathyroid adenoma. 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