Preoperative Localization and Intraoperative Parathyroid Hormone Assay in Korean Patients with Primary Hyperparathyroidism.
10.3803/EnM.2014.29.4.464
- Author:
Eirie CHO
1
;
Jung Mi CHANG
;
Seok Young YOON
;
Gil Tae LEE
;
Yun Hyi KU
;
Hong Il KIM
;
Myung Chul LEE
;
Guk Haeng LEE
;
Min Joo KIM
Author Information
1. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea. chorong24@gmail.com
- Publication Type:Original Article
- Keywords:
Parathyroid hormone;
Parathyroid neoplasms;
Hyperparathyroidism, primary;
Technetium Tc 99m sestamibi;
Ultrasonography
- MeSH:
Humans;
Hyperparathyroidism, Primary*;
Neck;
Parathyroid Glands;
Parathyroid Hormone*;
Parathyroid Neoplasms;
Parathyroidectomy;
Radionuclide Imaging;
Retrospective Studies;
Technetium Tc 99m Sestamibi;
Ultrasonography
- From:Endocrinology and Metabolism
2014;29(4):464-469
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The intraoperative parathyroid hormone (IOPTH) assay is widely used in patients with primary hyperparathyroidism (PHPT). We investigated the usefulness of the IOPTH assay in Korean patients with PHPT. METHODS: We retrospectively reviewed the data of 33 patients with PHPT who underwent parathyroidectomy. Neck ultrasonography (US) and 99mTc-sestamibi scintigraphy (MIBI scan) were performed preoperatively and IOPTH assays were conducted. RESULTS: The sensitivity of neck US and MIBI scans were 91% and 94%, respectively. A 50% decrease in parathyroid hormone (PTH) levels 10 minutes after excision of the parathyroid gland was obtained in 91% (30/33) of patients and operative success was achieved in 97% (32/33) of patients. The IOPTH assay was 91% true-positive, 3% true-negative, 0% false-positive, and 6% false-negative. The overall accuracy of the IOPTH assay was 94%. In five cases with discordant neck US and MIBI scan results, a sufficient decrease in IOPTH levels helped the surgeon confirm the complete excision of the parathyroid gland with no additional neck exploration. CONCLUSION: The IOPTH assay is an accurate tool for localizing hyperfunctioning parathyroid glands and is helpful for evaluating cases with discordant neck US and MIBI scan results.
