{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:34:14Z","timestamp":1787898854571,"version":"build-2784847793"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To investigate the incremental value of Sestamibi SPECT combined with a non-enhanced and contrast-enhanced CT, using SPECT\/CT, for the preoperative localisation of small parathyroid adenomas (PTA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospectively, 147 patients surgically cured from primary hyperparathyroidism, as verified by biochemistry 6\u00a0months postoperatively, were included. All patients had preoperatively undergone a dual time <jats:sup>99m<\/jats:sup>Technetium-Sestamibi SPECT (S) with multiphase CT including native (N), arterial (A) and venous (V) phases. Independently, two radiologists blinded from both the surgical and the preoperative imaging reports, sequentially performed PTA localisation starting with either [A] or [V], thereafter [A\u2009+\u2009N] or [V\u2009+\u2009N] and finally with the complete [A\u2009+\u2009N\u2009+\u2009S] or [V\u2009+\u2009N\u2009+\u2009S]. PTA localisation was reported for each image-set. The readers results were combined and the diagnostic performance for each image set was determined. Sensitivity was also calculated for the different quartiles of PTA weight distribution.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The median adenoma weight was 315\u00a0mg. No statistically significant differences in diagnostic performance between arterial and venous based image sets were found. The net effect of adding [N] was to increase specificity. Sestamibi SPECT significantly increased the overall diagnostic accuracy for arterial- and venous-based image sets, <jats:italic>p<\/jats:italic>\u2009=\u20090.0008 and <jats:italic>p<\/jats:italic>\u2009=\u20090.001, respectively. [A\u2009+\u2009N\u2009+\u2009S] was found to have the highest diagnostic performance with 86.5% sensitivity and 94.9% overall accuracy. [A\u2009+\u2009N\u2009+\u2009S] was particularly advantageous for locating PTA in the lower weight quartiles.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Native CT-phase and dual time point Sestamibi SPECT increase specificity and sensitivity, respectively. These, in combination with a single contrast-enhanced CT-phase is the most optimal examination protocol for preoperative localisation of PTA using SPECT\/CT.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13244-021-01016-3","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T19:02:35Z","timestamp":1622919755000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The preoperative localisation of small parathyroid adenomas improves when adding Tc-99m-Sestamibi SPECT to multiphase contrast-enhanced CT"],"prefix":"10.1186","volume":"12","author":[{"given":"Patricia","family":"Sandqvist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Farnebo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga-Lena","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Gryb\u00e4ck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Sundin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5964-0024","authenticated-orcid":false,"given":"Alejandro","family":"Sanchez-Crespo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"1016_CR1","doi-asserted-by":"publisher","first-page":"e109","DOI":"10.1097\/RLU.0000000000001447","volume":"42","author":"P Sandqvist","year":"2017","unstructured":"Sandqvist P, Nilsson IL, Gryback P, Sanchez-Crespo A, Sundin A (2017) SPECT\/CT\u2019s advantage for preoperative localization of small parathyroid adenomas in primary hyperparathyroidism. Clin Nucl Med 42:e109\u2013e114","journal-title":"Clin Nucl Med"},{"key":"1016_CR2","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1097\/RLU.0000000000002778","volume":"44","author":"P Sandqvist","year":"2019","unstructured":"Sandqvist P, Nilsson IL, Gryback P, Sanchez-Crespo A, Sundin A (2019) Multiphase iodine contrast-enhanced SPECT\/CT outperforms nonenhanced SPECT\/CT for preoperative localization of small parathyroid adenomas. Clin Nucl Med 44:929\u2013935","journal-title":"Clin Nucl Med"},{"key":"1016_CR3","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1097\/MNM.0000000000000818","volume":"39","author":"TB Andersen","year":"2018","unstructured":"Andersen TB, Aleksyniene R, Boldsen SK, Gade M, Bertelsen H, Petersen LJ (2018) Contrast-enhanced computed tomography does not improve the diagnostic value of parathyroid dual-phase MIBI SPECT\/CT. 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Written informed consent was obtained from all patients included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"72"}}