Preoperative Localization and Intraoperative Parathyroid Hormone Assay in Korean Patients with Primary Hyperparathyroidism
Endocrinology and Metabolism
; : 464-469, 2014.
Article
in En
| WPRIM
| ID: wpr-14708
Responsible library:
WPRO
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.Key words
Full text:
1
Index:
WPRIM
Main subject:
Parathyroid Hormone
/
Parathyroid Neoplasms
/
Parathyroid Glands
/
Radionuclide Imaging
/
Retrospective Studies
/
Parathyroidectomy
/
Ultrasonography
/
Technetium Tc 99m Sestamibi
/
Hyperparathyroidism, Primary
/
Neck
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Endocrinology and Metabolism
Year:
2014
Type:
Article