{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:29:55Z","timestamp":1788470995982,"version":"build-2803163510"},"reference-count":29,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T00:00:00Z","timestamp":1603929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Preoperative imaging is performed routinely to guide surgical management in primary hyperparathyroidism, but the optimal imaging modalities are debated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Our objectives were to evaluate which imaging modalities are associated with improved cure rate and higher concordance rates with intraoperative findings. A secondary aim was to determine whether additive imaging is associated with higher cure rate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design, Setting, and Patients<\/jats:title>\n                  <jats:p>This is a retrospective cohort review of 1485 adult patients during a 14-year period (2004-2017) at an academic tertiary referral center that presented for initial parathyroidectomy for de novo primary hyperparathyroidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Surgical cure rate, concordance of imaging with operative findings, and imaging performance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall cure rate was 94.1% (95% confidence interval, 0.93-0.95). Cure rate was significantly improved if sestamibi\/single-photon emission computed tomography (SPECT) was concordant with operative findings (95.9% vs. 92.5%, P\u2005=\u20050.010). Adding a third imaging modality did not improve cure rate (1 imaging type 91.8% vs. 2 imaging types 94.4% vs. 3 imaging types 87.2%, P\u2005=\u20050.59). Despite having a low number of cases (n\u2005=\u200528), 4-dimensional (4D) CT scan outperformed (higher sensitivity, specificity, positive predictive value, negative predictive value) all imaging modalities in multiglandular disease and double adenomas, and sestamibi\/SPECT in single adenomas.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Preoperative ultrasound combined with sestamibi\/SPECT were associated with the highest cure and concordance rates. If pathology was not found on ultrasound and sestamibi\/SPECT, additional imaging did not improve the cure rate or concordance. 4D CT scan outperformed all imaging modalities in multiglandular disease and double adenomas, and sestamibi\/SPECT in single adenomas, but these findings were underpowered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa779","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T13:50:54Z","timestamp":1603979454000},"page":"e328-e337","source":"Crossref","is-referenced-by-count":20,"title":["Use of Preoperative Imaging in Primary Hyperparathyroidism"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4964-7716","authenticated-orcid":false,"given":"David T","family":"Broome","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetes & Metabolism, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5146-8725","authenticated-orcid":false,"given":"Robert","family":"Naples","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bailey","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra","family":"Tekin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes & Metabolism, Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moska","family":"Hamidi","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Cleveland Clinic Foundation, Cleveland, 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