{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:19:27Z","timestamp":1790615967987,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,5]],"date-time":"2013-04-05T00:00:00Z","timestamp":1365120000000},"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":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to assess the accuracy of a novel imaging modality, three\u2010dimensional (3D) metabolic and radiologic gathered evaluation (MeRGE), for localizing parathyroid adenomas (PAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients presenting with primary hyperparathyroidism who underwent both thin\u2010slice cervical computed tomography (CT) and <jats:sup>99m<\/jats:sup>Tc\u2010sestamibi (MIBI) scanning were included. 3D\u2010CT reconstruction was obtained using VR\u2010RENDER, which was used to perform 3D virtual neck exploration (3D\u2010VNE). The MIBI scan was then fused with the 3D reconstruction to obtain 3D\u2010MeRGE. Sensitivity, specificity, and accuracy were assessed. Parathyroid gland volume and preoperative parathormone (PTH) levels were analyzed as predictive factors of correct localization (i.e., correct quadrant).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 108 cervical quadrants (27 patients) were analyzed. Sensitivities were 79.31, 75.86, 65.51, and 58.61 % with 3D\u2010MeRGE, 3D\u2010VNE, MIBI, and CT, respectively. Specificity was highest with CT (94.93 %) followed by 3D\u2010VNE (92.4 %). MIBI and 3D\u2010MeRGE had the same specificity (88.6 %). 3D\u2010MeRGE and 3D\u2010VNE achieved higher accuracy than MIBI or CT alone. Mean PTH values were significantly higher in patients with lesions that were correctly identified (true positive, TP) than in those whose lesions were missed (false negative, FN) with 3D\u2010VNE (219.60 \u00b1 212.77 vs. 98.75 \u00b1 12.76 pg\/ml; <jats:italic>p<\/jats:italic> = 0.01) and 3D\u2010MeRGE (217.69 \u00b1 213.76 vs. 09.75 \u00b1 20.48 pg\/ml; <jats:italic>p<\/jats:italic> = 0.02). The mean parathyroid gland volume difference between TP and FN was statistically significant with all modalities except CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>3D\u2010MeRGE and 3D\u2010VNE showed high accuracy for localization of PAs. 3D\u2010MeRGE performed better than MIBI or CT alone for detecting small adenomas and those with a low PTH level.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2021-x","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T19:59:04Z","timestamp":1365105544000},"page":"1618-1625","source":"Crossref","is-referenced-by-count":24,"title":["Three\u2010Dimensional Metabolic and Radiologic Gathered Evaluation Using VR\u2010RENDER Fusion: A Novel Tool to Enhance Accuracy in the Localization of Parathyroid Adenomas"],"prefix":"10.1002","volume":"37","author":[{"given":"Jacopo","family":"D\u2019Agostino","sequence":"first","affiliation":[{"name":"IRCAD\u2010IHU, University of Strasbourg 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