{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:36:25Z","timestamp":1783488985796,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,4,20]],"date-time":"2006-04-20T00:00:00Z","timestamp":1145491200000},"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":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Preoperative localization studies with Tc<jats:sup>99m<\/jats:sup>\u2010sestamibi have become an integral step in the preoperative assessment of patients with primary hyperparathyroidism (PHPT). This enables scan\u2010directed minimally invasive parathyroidectomy (MIP) to be the preferred treatment for PHPT in many units. This study aimed to identify factors that lead to negative imaging studies in patients with PHPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Over a 3\u2010year period consecutive unselected patients with PHPT underwent Tc<jats:sup>99m<\/jats:sup>\u2010sestamibi scanning and high\u2010resolution ultrasound (US) scanning by the same radiologist. When localization studies were concordant, patients underwent MIP. Those patients with negative imaging studies underwent bilateral neck exploration. Histology slides were independently reviewed and the proportion of chief cells and oxyphil cells within each adenoma was estimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and fifty\u2010eight patients underwent localization studies (38\u00a0men and120 women, aged 61.8 \u00b1 15.2 years). Sestamibi scans were negative in 52 (32%) and positive in 106 (68%) patients. There was a higher incidence of hyperplasia in the group of patients with negative sestamibi scans (4 out of 52 <jats:italic>vs.<\/jats:italic> 4 out of 103, <jats:italic>P<\/jats:italic> &lt; 0.05, \u03c7<jats:sup>2<\/jats:sup> test). In patients with negative sestamibi scans the majority of adenomas were formed predominantly from chief cells (26 out of 36) while the majority of patients with adenomas composed predominantly of oxyphil cells had positive scans (21 out of 23) (<jats:italic>P<\/jats:italic> &lt; 0.05, \u03c7<jats:sup>2<\/jats:sup> test). The weight of parathyroid adenomas was higher when sestamibi scans were positive (median: 1,180 <jats:italic>vs.<\/jats:italic> 517\u00a0mg, <jats:italic>P<\/jats:italic> &lt; 0.05, Student\u2019s <jats:italic>t<\/jats:italic>\u2010test).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Successful preoperative localization of parathyroid adenomas using Tc<jats:sup>99m<\/jats:sup>\u2010sestamibi scanning is influenced by the cytological predominance of individual tumors. Negative scans might therefore be unavoidable in a subgroup of patients.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0338-9","type":"journal-article","created":{"date-parts":[[2006,4,19]],"date-time":"2006-04-19T07:43:32Z","timestamp":1145432612000},"page":"697-704","source":"Crossref","is-referenced-by-count":100,"title":["Negative Imaging Studies for Primary Hyperparathyroidism Are Unavoidable: Correlation of Sestamibi and High\u2010Resolution Ultrasound Scanning with Histological Analysis in 150\u00a0Patients"],"prefix":"10.1002","volume":"30","author":[{"given":"Radu","family":"Mihai","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery John Radcliffe Hospital Headley Way OX3 7LJ Headington Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergus","family":"Gleeson","sequence":"additional","affiliation":[{"name":"Department of Radiology John Radcliffe Hospital Headley Way OX3 7LJ Headington Oxford 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