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Factors influencing sensitivity of sestamibi-SPECT scan
Factors		Sensitivity
Biochemical factors	High serum calcium level	Increased
	High serum parathyroid hormone level	Increased
	Vitamin D deficiency	Increased
	Calcium channel blocker use	Decreased
Gross architectural factors	Size (Larger)	Increased
	Multi-glandular disease	Decreased
Cytological factors	Increased amount of cellular content (Chief cells and oxyphil cells)	Increased
Immunohistochemical factors	Increased P-glycoprotien expression	Decreased