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The present study evaluated the impact of hybrid single photon emission computed tomography\/computed tomography (SPECT\/CT), using <jats:sup>99m<\/jats:sup>Tc\u2010sestamibi (MIBI), on the surgical management of these patients. In a retrospective study of 36 patients with PHPT, SPECT\/CT was undertaken when planar <jats:sup>99m<\/jats:sup>Tc\u2010MIBI scintigraphy was negative or when an ill\u2010defined focus in the neck or an ectopic site on planar views was visualized. Imaging data were compared with intraoperative findings, and the incremental value of SPECT\/CT to lesion localization and surgical procedure was assessed. Three patients with both negative planar and SPECT\/CT studies subsequently underwent bilateral neck exploration, with multiglandular hyperplasia diagnosed in two patients and a parathyroid adenoma in one. Of 33 patients with a positive MIBI study, parathyroid adenoma was confined to the neck in 23 patients and to the lower neck\u2010mediastinum in 10. SPECT\/CT facilitated the surgical exploration of all 10 ectopic parathyroid adenomas and 4 of 23 cervical parathyroid adenomas, the latter four either at reexploration or in patients with nonvisualization of the thyroid after thyroidectomy. SPECT\/CT contributed to the localization of parathyroid adenomas in patients with PHPT and to planning the surgical exploration in 14 of 36 (39%) patients, predominantly those with ectopic parathyroid adenomas or who had distorted neck anatomy.<\/jats:p>","DOI":"10.1007\/s00268-005-7849-2","type":"journal-article","created":{"date-parts":[[2005,12,20]],"date-time":"2005-12-20T10:38:03Z","timestamp":1135075083000},"page":"76-83","source":"Crossref","is-referenced-by-count":107,"title":["Technetium\u201099m\u2010MIBI SPECT\/CT in Primary Hyperparathyroidism"],"prefix":"10.1002","volume":"30","author":[{"given":"Yodphat","family":"Krausz","sequence":"first","affiliation":[{"name":"Department of Medical Biophysics and Nuclear Medicine Hadassah\u2010Hebrew University Medical Center PO Box 12000 91120 Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise","family":"Bettman","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Rambam 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