{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T21:41:27Z","timestamp":1783633287412,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,19]],"date-time":"2018-11-19T00:00:00Z","timestamp":1542585600000},"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":["Clinical Endocrinology"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objective<\/jats:title>\n                    <jats:p>Intraoperative parathyroid hormone (IOPTH) monitoring during surgery for primary hyperparathyroidism (PHPT) could improve cure rate and simplify current care pathways. This study assesses the performance of US, MIBI and IOPTH monitoring and their impact on outcomes and perioperative strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a retrospective study of a prospectively maintained database of patients who underwent parathyroidectomy guided by preoperative US, MIBI and IOPTH monitoring. Test performance (sensitivity, specificity, PPV, NPV, accuracy) and IOPTH added value (percentage of patients in whom test contributed to achieving cure) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 617 patients (median age 59\u00a0years, 75% females), 603 (97.7%) of them cured, were included in analysis. Sensitivity of US was higher than MIBI (78.2% vs 70%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), but both were inferior to IOPTH (98.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). US and MIBI were more sensitive at detecting single gland disease (SGD) than multigland disease (MGD) (85% vs 55% and 77.5% vs 45.5%, respectively,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), while IOPTH performed well in both situations (98.8% vs 96.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&gt;\u00a00.05). In 41 patients with incorrect US predictions, MIBI gave correct result only in 12 (29.3%) cases, while IOPTH gave correct predictions in all but one patient (97.6%). Minimally invasive parathyroidectomy (MIP) was completed in 409 patients, with a similar completion rate regardless whether both or one scan was positive. IOPTH added value was significant in whole cohort (14%) and in subgroups of patients with concordant vs discordant scans, minimally invasive vs conventional surgery, and initial vs reoperative surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intraoperative parathyroid hormone monitoring is more accurate at predicting cure than US and MIBI are at identifying abnormal glands in patients undergoing parathyroidectomy for PHPT and significantly contributes to cure rate in range of clinical scenarios. This implies that its routine use could facilitate successful surgery in patients with single positive imaging and increase number of MIPs while maintaining high cure rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.13882","type":"journal-article","created":{"date-parts":[[2018,10,22]],"date-time":"2018-10-22T11:00:47Z","timestamp":1540206047000},"page":"277-284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Impact of intraoperative parathyroid hormone monitoring on the management of patients with primary hyperparathyroidism"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3230-5154","authenticated-orcid":false,"given":"Michael","family":"Shawky","sequence":"first","affiliation":[{"name":"Centre for Endocrine Surgery University College London Hospital &amp; London Clinic London UK"},{"name":"Department of General Surgery Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Abdel Aziz","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery University College London Hospital &amp; London Clinic London UK"},{"name":"Department of General Surgery Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Morley","sequence":"additional","affiliation":[{"name":"Department of Radiology University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Beale","sequence":"additional","affiliation":[{"name":"Department of Radiology University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamshed","family":"Bomanji","sequence":"additional","affiliation":[{"name":"Institute of Nuclear Medicine University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Soromani","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Philips","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Matias","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery University College London Hospital &amp; London Clinic London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Honour","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Smart","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia University College London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom R.","family":"Kurzawinski","sequence":"additional","affiliation":[{"name":"Centre for Endocrine Surgery University College London Hospital &amp; London Clinic London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,19]]},"reference":[{"issue":"1","key":"e_1_2_6_2_1","first-page":"58","article-title":"Primary hyperparathyroidism","volume":"32","author":"Madkhali T","year":"2016","journal-title":"Turkish J Surg\/Ulusal Cerrahi Dergisi"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588403766274926"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03520.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1413"},{"issue":"2","key":"e_1_2_6_6_1","first-page":"S217","article-title":"Hyperparathyroidism: cancer and mortality","volume":"16","author":"Goswami S","year":"2012","journal-title":"Indian J Endocrinol Metab"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03958.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2014.12.003"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.9.1055"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(05)80101-1"},{"issue":"7","key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1007\/s00423-016-1510-4","article-title":"Clinical value of ultrasound, MIBI and intra\u2010operative parathyroid hormone monitoring in patients with Hyperparathyroidism. Joint Meeting of the German Association of Endocrine Surgeons (CAEK) and the British Association of Endocrine and Thyroid Surgeons (BAETS)","volume":"401","author":"Shawky M","year":"2016","journal-title":"Langenbecks Arch Surg"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.5.472"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.183451"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4473"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.05.003"},{"issue":"188","key":"e_1_2_6_16_1","first-page":"2","article-title":"MIBI SPECT scan and ultrasonography in preoperative imaging of primary hyperparathyroidism","volume":"4","author":"Batawil N","year":"2015","journal-title":"OMICS J Radiol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.2.183"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/921260"},{"key":"e_1_2_6_19_1","first-page":"190","article-title":"Modern Parathyroid Surgery and Intra\u2010Operative Hormone Monitoring; Present Status, Future Concepts","volume":"9","author":"Shawky M","year":"2018","journal-title":"J Steroids Horm Sci"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.06.046"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7708-6"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-009-0510-z"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-009-0505-9"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.4.381"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7600-4"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2003.10.014"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-017-0188-0"},{"issue":"4","key":"e_1_2_6_28_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/poc.0b013e3181126ef1","article-title":"The National Academy of Clinical Biochemistry Laboratory Medicine practice guidelines for intraoperative parathyroid hormone","volume":"6","author":"Sokoll LJ","year":"2007","journal-title":"Point of Care"},{"key":"e_1_2_6_29_1","unstructured":"EzzatT PhilipsI HonourJ PreteF SmartJ KurzawinskiTR.Intraoperative Parathyroid Hormone measurement during Parathyroidectomy is cost effective. In: 33rd BAETS Annual Scietific Meeting; 9\u201011 Oct2013; Rome."},{"issue":"7","key":"e_1_2_6_30_1","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1007\/s00423-016-1510-4","article-title":"New management paradigm for patients with Primary Hyperparathyroidism (PHPT) and single abnormal parathyroid gland identified by preoperative ultrasound. Joint Meeting of the German Association of Endocrine Surgeons (CAEK) and the British Association of Endocrine and Thyroid Surgeons (BAETS)","volume":"401","author":"Shawky M","year":"2016","journal-title":"Langenbecks Arch Surg"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcen.13882","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.13882","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.13882","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.13882","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T16:45:58Z","timestamp":1694364358000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.13882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,19]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1111\/cen.13882"],"URL":"https:\/\/doi.org\/10.1111\/cen.13882","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.734273514.793571286","asserted-by":"object"}]},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"value":"0300-0664","type":"print"},{"value":"1365-2265","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,19]]},"assertion":[{"value":"2018-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}