{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:10:54Z","timestamp":1789020654228,"version":"build-2803163510"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T00:00:00Z","timestamp":1550534400000},"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":["Ear Nose Throat J"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>\n                    Localization of parathyroid adenomas for treatment of primary hyperparathyroidism can be challenging. This retrospective study compared single-photon emission computed tomography\/computed tomography (SPECT\/CT), 4D-CT, and US studies in detection of adenomas prior to surgery. A retrospective chart review was performed on all consecutive patients with parathyroid adenoma presenting to an urban tertiary care medical center. A total of 58 patients (45 female, 13 male) underwent surgery for parathyroid adenoma. Patients aged 28 to 80 years (mean: 58.8) with parathyroid hormone levels ranging from 42 to 424 pg\/mL (mean: 168). All patients underwent preoperative SPECT\/CT with 20 mCi technetium-99m MIBI (\n                    <jats:sup>99m<\/jats:sup>\n                    Tc-MIBI). Fifty-three patients had additional US imaging and 14 patients had 4D-CT scans. Additionally, 34 patients had injection of 20 mCi\n                    <jats:sup>99m<\/jats:sup>\n                    Tc-MIBI on the day of surgery. Pathological correlation was performed. Comparing SPECT\/CT versus 4D-CT resulted in sensitivity (77% vs 80%), specificity (71% vs 75%), and accuracy (77% vs 79%). Ultrasound was less sensitive with similar specificity (44%, 86%, respectively). Combination of SPECT\/CT and 4D-CT increased sensitivity to 88%, specificity to 100%, and accuracy to 89%. Combining SPECT\/CT with US resulted in sensitivity of 85%, specificity of 83%, and accuracy of 85%. Intraoperative localization substantially improved in patients who received preoperative injections. The SPECT\/CT remains the best imaging modality for preoperative localization of parathyroid adenomas with high sensitivity. Combining SPECT\/CT with US resulted in increased sensitivity and accuracy. For suspicion of ectopic cases or suspicion of unidentifiable adenoma with negative scintigraphy, addition of 4D-CT is recommended. Intraoperative localization and adjunctive imaging may improve surgical management of patients with hyperparathyroidism.\n                  <\/jats:p>","DOI":"10.1177\/0145561319828668","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T23:29:59Z","timestamp":1550618999000},"page":"149-157","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Clinical Value of Tc99m-MIBI SPECT\/CT Versus 4D-CT or US in Management of Patients With Hyperparathyroidism"],"prefix":"10.1177","volume":"98","author":[{"given":"Suraj","family":"Kedarisetty","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Lewis Katz School of Medicine, Temple University School of Medicine, Philadelphia, PA, 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