{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:22:43Z","timestamp":1760984563588},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,6,7]],"date-time":"2012-06-07T00:00:00Z","timestamp":1339027200000},"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":[[2012,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ultrasound (US) and sestamibi (MIBI) are traditionally considered positive or negative. The purpose of this study was to define and test a new scoring system for MIBI and US and to determine whether this can improve their accuracy for primary hyperparathyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective study of 200 consecutive patients with primary hyperparathyroidism who had a single uptake on MIBI scans before bilateral neck exploration at a tertiary academic center between 2007 and 2008. These patients also had surgeon\u2010performed neck US in the office, which was scored as \u201ctypical\u201d or \u201catypical\u201d based on how characteristic the image resembled a parathyroid gland. The MIBI uptake was scored by the nuclear medicine specialist as \u201cweak,\u201d \u201cmoderate,\u201d or \u201cstrong\u201d compared with the signal intensity of the thyroid. US and MIBI scoring was done preoperatively and their findings were compared with operative data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 200 patients, 71 % had a single adenoma, 12 % had double adenomas, and 17 % had four\u2010gland hyperplasia. A weak, moderate, and strong signal on MIBI had an accuracy of 23, 47, and 72 %, respectively, in demonstrating single\u2010gland disease. An atypical versus typical US appearance was accurate in 55 and 74 % of the time, in identifying single\u2010gland disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An appraisal of US and MIBI positivity in relation to image characteristics affects the reliability of both studies. This information should be kept in mind when selecting patients for focal neck exploration.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-012-1666-1","type":"journal-article","created":{"date-parts":[[2012,6,6]],"date-time":"2012-06-06T18:26:38Z","timestamp":1339007198000},"page":"2516-2521","source":"Crossref","is-referenced-by-count":5,"title":["A New Classification of Positive Sestamibi and Ultrasound Scans in Parathyroid Localization"],"prefix":"10.1002","volume":"36","author":[{"given":"Orhan","family":"Agcaoglu","sequence":"first","affiliation":[{"name":"Division of Endocrine Surgery Endocrinology and Metabolism Institute, Cleveland Clinic 9500 Euclid Avenue\/F20 44195 Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamil","family":"Aliyev","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery Endocrinology and Metabolism Institute, Cleveland Clinic 9500 Euclid Avenue\/F20 44195 Cleveland OH 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