{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:53:05Z","timestamp":1761562385497,"version":"3.37.3"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,6,7]],"date-time":"2018-06-07T00:00:00Z","timestamp":1528329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Highly specific preoperative localizing test is required to select patients for minimally invasive parathyroidectomy (<jats:styled-content style=\"fixed-case\">MIP<\/jats:styled-content>) in lieu of traditional four\u2010gland exploration. We hypothesized that Tc\u201099m sestamibi scan interpretation incorporating numerical measurements on the degree of asymmetrical activity from bilateral thyroid beds can be useful in localizing single adenoma for <jats:styled-content style=\"fixed-case\">MIP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We devised a quantitative interpretation method for Tc\u201099m sestamibi scan based on the numerically graded asymmetrical activity on early phase. The numerical ratio value of each scan was obtained by dividing the number of counts from symmetrically drawn regions of interest (<jats:styled-content style=\"fixed-case\">ROI<\/jats:styled-content>) over bilateral thyroid beds. The final pathology and clinical outcome of 109 patients were used to perform receiver operating curve (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Receiver operating curve analysis revealed the area under the curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) was calculated to be 0.71 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0032), validating this method as a diagnostic tool. The optimal cut\u2010off point for the ratio value with maximal combined sensitivity and specificity was found with corresponding sensitivity of 67.9% (56.5\u201377.2%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) and specificity of 75.0% (52.8\u201391.8%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>). An additional higher cut\u2010off with higher specificity with minimal possible sacrifice on sensitivity was also selected, yielding sensitivity of 28.6% (18.8\u201338.6%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) and specificity of 90.0% (69.6\u201398.8%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results demonstrated that the more asymmetrical activity on the initial phase, the more successful it is to localize a single parathyroid adenoma on sestamibi scans. Using early\u2010phase Tc\u201099m sestamibi scan only, we were able to select patients for minimally invasive parathyroidectomy with 90% specificity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.12753","type":"journal-article","created":{"date-parts":[[2018,6,7]],"date-time":"2018-06-07T11:58:18Z","timestamp":1528372698000},"page":"642-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Highly specific preoperative selection of solitary parathyroid adenoma cases in primary hyperparathyroidism by quantitative image analysis of the early\u2010phase Technetium\u201099m sestamibi scan"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6974-3529","authenticated-orcid":false,"given":"DaeHee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiology Lahey Hospital and Medical Center Burlington Massachusetts 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