{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:44:54Z","timestamp":1791492294514,"version":"4.3.4"},"reference-count":24,"publisher":"Institute of Physiology of the Czech Academy of Sciences","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Physiol Res"],"abstract":"<jats:p>Inconclusive preoperative imaging is a strong predictor of multiglandular parathyroid disease (MGD) in patients with primary hyperparathyroidism (PHPT). MGD was investigated in a cohort of 17 patients with PHPT (mean age 64.9 years, total calcium 2.75 mmol\/l and parathyroid hormone (PTH) 113.3 ng\/l) who underwent 18F-fluorocholine PET\/CT (FCH) imaging before surgery. The initial MIBI SPECT scintigraphy (MIBI) and\/or neck ultrasound were not conclusive or did not localize all pathological parathyroid glands, and PHPT persisted after surgery. Sporadic MGD was present in 4 of 17 patients with PHPT (24 %). In 3 of 4 patients with MGD, FCH correctly localized 6 pathological parathyroid glands and surgery was successful. Excised parathyroid glands were smaller (p &lt;0.02) and often hyperplastic in MGD than in single gland disease. In two individuals with MGD, excision of a hyperplastic parathyroid gland led to a false positive decline in intraoperative PTH and\/or postoperative serum calcium. Although in one patient it was associated with partial false negativity, parathyroid imaging with FCH seemed to be superior to neck ultrasound and\/or MIBI scintigraphy in MGD.<\/jats:p>","DOI":"10.33549\/physiolres.934851","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T12:02:18Z","timestamp":1652788938000},"page":"233-240","source":"Crossref","is-referenced-by-count":5,"title":["Multiglandular Parathyroid Disease in Primary Hyperparathyroidism With Inconclusive Conventional Imaging"],"prefix":"10.33549","author":[{"given":"K","family":"Zaj\u00ed\u010dkov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"V\u010del\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Le\u0161kov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Grega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Goltzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Zogala","sequence":"additional","affiliation":[{"name":"Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic. david.zogala@vfn.cz"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"19169","published-online":{"date-parts":[[2022,4,30]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Barczy\u0144ski M, Br\u00e4nstr\u00f6m R, Dionigi G, Mihai R. 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