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Authors Burke JF, Naraharisetty K, Schneider DF, Sippel RS, Chen H
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Journal Am. J. Surg. Volume: 205 Issue: 3 Pages: 269-73; discussion 273
Publish Date 2013 Mar
PubMed ID 23351511
PMC ID 3640407
Abstract

In hyperparathyroidism, dual-phase technetium-99m sestamibi scintigraphy is important for parathyroid adenoma localization. We hypothesized that reviewing early-phase scans can increase localization in patients with primary hyperparathyroidism (PHPT).We reviewed our prospectively maintained database for patients with sestamibi scans before parathyroidectomy for PHPT from 2001 to 2011. Early-phase scans were read and compared with the location of the gland(s) removed at operation.Of 902 patients identified, radiologists read 693 scans as positive. Of 209 negative scans, 141 (67%) were positive in the early phase; 135 (96%) correctly identified the side of the adenoma. Using radiologist reads, 35% of patients with negative scans and 41% of patients with falsely localized glands required bilateral exploration compared with 5% of patients with correctly localized glands.A review of early scans in patients with negative imaging increases accurate adenoma localization and allows for minimally invasive operations in more patients.

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