title: Use of the gamma probe to identify multigland disease in primary hyperparathyroidism.
abstract: OBJECTIVE
  The purpose of this study was to determine threshold gamma probe counts to distinguish single adenoma (SA) from multigland disease (MGD) during radioguided parathyroidectomy.
  
  
  METHODS
  A retrospective analysis of 1656 patients was performed.Ex vivocounts of the first excised gland were taken and recorded as a percentage of background counts.
  
  
  RESULTS
  69.4% of MGD patients had counts below the 50% threshold. The 50% threshold correctly grouped 72.8% of our cohort. Counts of more than 100% were accurate for grouping SA, with only 6.8% of patients with counts more than 100% having MGD.
  
  
  CONCLUSIONS
  The gamma probe can aid surgeons in deciding to continue neck exploration if MGD is suspected or wait for labs to confirm cure if SA is suspected.
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Kirby
authors.initials: K
authors.lastname: Tobin
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Ayers
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rajaei
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Sippel
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Courtney J
authors.initials: CJ
authors.lastname: Balentine
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Elfenbein
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: Herb
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Surgery, University of Wisconsin, K3/739 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Schneider
keywords: gamma probe; multigland disease; primary hyperparathyroidism; radioguided parathyroidectomy; radionuclide counts; single adenoma; threshold