{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T21:06:29Z","timestamp":1777755989661,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Previous studies have demonstrated that C\n                      <jats:sup>11<\/jats:sup>\n                      choline positron emission tomography\/computed tomography (Choline-PET\/CT) can localize abnormal parathyroid glands in the reoperative setting. This study assesses a large volume of patients with primary hyperparathyroidism (1HPT) who underwent Choline-PET\/CT to confirm its utility in the setting of negative or equivocal conventional imaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients who underwent Choline-PET\/CT for evaluation of 1HPT from July 2017 to July 2024 at a single institution were reviewed. Inclusion criteria were patients who underwent parathyroidectomy and had lab testing to assess for cure (defined as &gt;50% drop from baseline PTH and into normal range, or resolution of hypercalcemia at follow-up). Sensitivity, positive predictive value (PPV), false negative rate (FNR), and accuracy were compared to conventional imaging (neck ultrasound, parathyroid scan, and parathyroid four-dimensional CT (4D-CT)). Subgroup analysis was conducted comparing sensitivity of modalities among index operations and separately in reoperations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>84 patients were included for analysis. 61 failed to localize on at least one conventional modality, and 15 failed to localize on all conventional studies. 67 patients (80%) achieved cure, of which 53 were reoperations. Choline-PET\/CT outperformed conventional modalities across sensitivity, PPV, FNR, and accuracy. Choline-PET\/CT also outperformed conventional modalities when comparing sensitivity in both subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      C\n                      <jats:sup>11<\/jats:sup>\n                      choline-PET\/CT is a valuable imaging modality in the reoperative setting and demonstrates utility for index operations. It provides localization when other modalities fail and allows for a high surgical cure rate. Further investigation into its utility as a primary imaging modality is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251413528","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T09:22:54Z","timestamp":1767691374000},"page":"1806-1812","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["C\n                    <sup>11<\/sup>\n                    Choline-PET\/CT as a Localization Standard for Reoperative Primary Hyperparathyroidism"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4311-9138","authenticated-orcid":false,"given":"Peter","family":"Hopmann","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Lund","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0423-2370","authenticated-orcid":false,"given":"Trenton","family":"Foster","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benzon","family":"Dy","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis","family":"McKenzie","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey B.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Wermers","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Lyden","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"issue":"2","key":"e_1_3_3_2_2","first-page":"N18","article-title":"Epidemiology of primary hyperparathyroidism in Europe","volume":"17","author":"Adami S","year":"2002","unstructured":"Adami S, Marcocci C, Gatti D. Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res. 2002;17(Suppl 2):N18-N23.","journal-title":"J Bone Miner Res"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(97)90357-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4665"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3389-6"},{"issue":"6","key":"e_1_3_3_6_2","first-page":"966","article-title":"Parathyroid imaging with technetium-99m-Sestamibi: an initial institutional experience","volume":"116","author":"Thompson GB","year":"1994","unstructured":"Thompson GB, Mullan BP, Grant CS, et al. Parathyroid imaging with technetium-99m-Sestamibi: an initial institutional experience. Surgery. 1994;116(6):966-972. discussion 972e973.","journal-title":"Surgery"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13550-019-0534-5"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2022.08.024"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.18312"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e31824c5ffc"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.119.233213"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","unstructured":"Ismail A Anja J Krakauer M et al. 11C-Choline PET\/CT vs. 99mTc-MIBI\/123Iodide subtraction SPECT\/CT for preoperative detection of abnormal parathyroid glands in primary hyperparathyroidism: a prospective single-centre clinical trial in 60 patients. 2020;10(11):975. doi:10.3390\/diagnostics10110975.","DOI":"10.3390\/diagnostics10110975"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13550-021-00778-7"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000000607"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14688"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2023.12.011"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-023-06488-7"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.7150\/jca.91483"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2021.0915"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41824-021-00108-z"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-018-4123-z"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251413528","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251413528","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251413528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:19:10Z","timestamp":1777465150000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251413528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/00031348251413528"],"URL":"https:\/\/doi.org\/10.1177\/00031348251413528","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]}}}