{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:48:12Z","timestamp":1787878092955,"version":"build-2784847793"},"reference-count":37,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T00:00:00Z","timestamp":1285891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Although\n                      <jats:sup>99m<\/jats:sup>\n                      Technetium-sestamibi scintigraphy with single-photon emission computed tomography (SPECT) and, recently, hybrid SPECT\/computed tomography (CT) have been claimed to be the preoperative methods of choice for parathyroid localization in patients with primary hyperparathyroidism (PHPT) and concomitant nodular goiter (NG), they have never been compared in this setting. We aimed at testing the hypothesis that SPECT\/CT may be superior to SPECT for parathyroid localization in patients with PHPT and NG.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Thirty-three patients with PHPT and NG (one or more nodular lesions based on cervical ultrasound) who underwent open parathyroidectomy during 2004\u20132009 were reviewed. All patients had preoperative\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-sestamibi planar scintigraphy and SPECT (18 patients) or SPECT\/CT (15 patients) after cervical ultrasound. Sensitivity, specificity, and positive predictive value (PPV) (for both correct neck side and quadrant identification) were calculated for the two procedures through comparison with intraoperative findings. In addition, operative times were assessed if the surgery was only for PHPT and not for the six patients who also had thyroidectomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The sensitivity of SPECT\/CT for correctly identifying the neck side containing an abnormal parathyroid was 93.7% versus 80% for SPECT (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.21, not significant [ns]). The specificity and PPV for this attribute were 92.9% and 93.7%, respectively, for SPECT\/CT versus 87.5% and 88.9%, respectively, for SPECT (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.75 and 0.8, ns). SPECT\/CT showed higher sensitivity than SPECT (87.5% vs. 55.6%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0001) and higher PPV (87.5% vs. 62.5%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0022) for correctly identifying the neck quadrant affected by PHPT. The specificity for this was 95.5% for SPECT\/CT versus 88.5% for SPECT (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.26, ns). Mean operative time was shorter after SPECT\/CT than after SPECT (38 vs. 56 minutes;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.034). One of the patients having SPECT\/CT had double adenomas, and two had ectopic parathyroid glands, all of which were recognized preoperatively by this technique. Two of the patients having SPECT had double adenomas, and two had ectopic glands, none of which were recognized preoperatively. No patient had persistent or recurrent PHPT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SPECT\/CT is superior to SPECT for preoperative imaging of patients with PHPT and NG. We recommend the routine use of SPECT\/CT for work-up of all such patients, particularly if minimally invasive parathyroid surgery is planned.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2010.0035","type":"journal-article","created":{"date-parts":[[2010,7,8]],"date-time":"2010-07-08T15:44:09Z","timestamp":1278603849000},"page":"1121-1127","source":"Crossref","is-referenced-by-count":51,"title":["Clinical Appraisal of\n                    <sup>99m<\/sup>\n                    Technetium-Sestamibi SPECT\/CT Compared to Conventional SPECT in Patients with Primary Hyperparathyroidism and Concomitant Nodular Goiter"],"prefix":"10.1177","volume":"20","author":[{"given":"Giacomo","family":"Pata","sequence":"first","affiliation":[{"name":"University of Brescia","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Casella","sequence":"additional","affiliation":[{"name":"University of Brescia","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul","family":"Besuzio","sequence":"additional","affiliation":[{"name":"University of Brescia","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Mittempergher","sequence":"additional","affiliation":[{"name":"University of Brescia","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Salerni","sequence":"additional","affiliation":[{"name":"University of Brescia","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,10,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(02)01897-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2006.0182"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/105072502321085207"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2008.09.012"},{"key":"e_1_3_3_6_2","first-page":"1801","article-title":"Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study)","volume":"33","author":"Taillefer R","year":"1992","unstructured":"Taillefer R, , Boucher Y, , Potvin C, , Lambert R. 1992. Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study) J Nucl Med, 33:1801\u20131807.","journal-title":"J Nucl Med"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-200204000-00002"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-200112000-00001"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02439546"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002680010280"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-009-1131-z"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200211000-00001"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004230050207"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-002-6695-8"},{"key":"e_1_3_3_15_2","first-page":"248","article-title":"The value of 99mTc-sestamibi SPECT\/CT over conventional SPECT in the evaluation of parathyroid adenomas or hyperplasia","volume":"46","author":"Gayed IW","year":"2005","unstructured":"Gayed IW, , Kim EE, , Broussard WF, , Evans D, , Lee J, , Broemeling LD, , Ochoa BB, , Moxley DM, , Erwin WD, , Podoloff DA. 2005. The value of 99mTc-sestamibi SPECT\/CT over conventional SPECT in the evaluation of parathyroid adenomas or hyperplasia. J Nucl Med, 46:248\u2013252.","journal-title":"J Nucl Med"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-006-0098-0"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2006.07.028"},{"key":"e_1_3_3_18_2","volume-title":"Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources","author":"Administration of Radioactive Substances Advisory Committee (ARSAC)","year":"2006","unstructured":"Administration of Radioactive Substances Advisory Committee (ARSAC). 2006. Notes for Guidance on the Clinical Administration of Radiopharmaceuticals and Use of Sealed Radioactive Sources. 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The negative sestamibi scan: is a minimally invasive parathyroidectomy still possible? 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