{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T18:12:52Z","timestamp":1770142372196,"version":"3.49.0"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health Ricerca Corrente","award":["CDC 099173"],"award-info":[{"award-number":["CDC 099173"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aims to present the evolution of our center\u2019s approach to treating primary hyperparathyroidism (PHPT) from diagnosis to intraoperative interventions. We have also evaluated the intraoperative localization benefits of indocyanine green fluorescence angiography. This retrospective single-center study involved 296 patients who underwent parathyroidectomy for PHPT between January 2010 and December 2022. The preoperative diagnostic procedure included neck ultrasonography in all patients, [99mTc]Tc-MIBI scintigraphy in 278 patients, and, in 20 doubtful cases, [18F] fluorocholine positron emission tomography (PET) computed tomography (CT) was performed. Intraoperative PTH was measured in all cases. Indocyanine green has been administered intravenously since 2020 to guide surgical navigation using a fluorescence imaging system. The development of high precision diagnostic tools that can localize an abnormal parathyroid gland in combination with intra-operative PTH assay (ioPTH) enables the surgical treatment of PHPT patients with focused approaches and excellent results that are stackable with bilateral neck exploration (98% of surgical success). Indocyanine green angiography has the potential to assist surgeons in identifying parathyroid glands rapidly and with minimal risk, especially when pre-operative localization has failed. When everything else fails, it is only an experienced surgeon who can resolve the situation.<\/jats:p>","DOI":"10.3390\/jcm12052057","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T02:06:43Z","timestamp":1678068403000},"page":"2057","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evolution of the Diagnosis and Treatment of Primary Hyperparathyroidism"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4781-8013","authenticated-orcid":false,"given":"Enrico","family":"Battistella","sequence":"first","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Pomba","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Toniato","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Padua, Via Giustiniani 2, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Burei","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Gregianin","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-0423","authenticated-orcid":false,"given":"Sara","family":"Watutantrige Fernando","sequence":"additional","affiliation":[{"name":"Familial Cancer Unit, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Toniato","sequence":"additional","affiliation":[{"name":"Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1210\/jc.2012-4022","article-title":"Incidence and prevalence of primary hyperparathyroidism in a racially mixed population","volume":"98","author":"Yeh","year":"2013","journal-title":"J. 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