ArticleThe oncologist2025
Using ex vivo radioactivity measurement to differentiate parathyroid single-gland and multigland disease.
Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Incidence of Ectopic Parathyroid Glands in Primary, Secondary, and Tertiary Hyperparathyroidism.The Journal of surgical research · 2026Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRadioguided parathyroidectomy is based on the principle that hyperfunctioning parathyroid glands have increased radiotracer uptake, which can be measured instantaneously. We sought to determine if ex vivo radioactivity measurement could be used to predict parathyroid pathology and guide surgical decision-making in a time-efficient manner. Materials and Methods: We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy at our institution (2000-2022). All patients received a preoperative injection of 10mCi of 99Tc. Intraoperatively, radioactivity was measured by a gamma counter within 5 seconds. The ratio of radioactive counts of resected parathyroid glands (ex vivo) to background thyroid tissue (radioactive ratio [RR]) was calculated. Patient demographics, preoperative laboratory measurements, and RRs were compared between patients with single-gland disease (SGD) versus multigland disease (MGD). The predictive threshold for SGD was subsequently validated on the following cohort of 115 patients.
resultsOf 2368 patients included, 1585 (66.9%) patients had SGD, and 783 (33.1%) had MGD. Patients with SGD had higher median (IQR) RRs than the MGD group (0.8 [0.5-1.3] vs 0.4 [0.3-0.7], P <.001). After adjusting for age, preoperative calcium and PTH, reoperative parathyroidectomy, and gland weight, the RR was an independent predictor (OR 2.155, P <.001) of SGD. A receiver operating characteristic curve was plotted using the RR to predict the likelihood of SGD. The positive predictive value (PPV) reached a plateau at 85.3% when RR was 1.2. When the threshold of 1.2 was used in the validation cohort, the PPV was 92.3%.
conclusionsEx vivo radioactivity measurement provides an instantaneous and reliable prediction of parathyroid pathology, which could be used as an adjunct to guide surgical decision-making during parathyroidectomy.
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