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Preoperative parathyroid radioisotope scanning is of little or no value in patients with multiple endocrine neoplasia type 1 when 4 or more hypertrophied glands are present. Scanning using technetium Tc 99m sestamibi and single photon emission computed tomography will achieve a high level of sensitivity and specificity after 3 or more glands have previously been removed, justifying limited surgical reexploration.

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Preoperative Sestamibi Scanning and Surgical Findings at Bilateral, Unilateral, or Minimal Reoperation for Recurrent Hyperparathyroidism After Subtotal Parathyroidectomy in Patients With Multiple Endocrine Neoplasia Type 1