CLC number: R58
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2009-02-03
Cited: 12
Clicked: 6874
Massimo GIUSTI, Mara DOLCINO, Lara VERA, Carla GHIARA, Francesca MASSARO, Laura FAZZUOLI, Diego FERONE, Michele MUSSAP, Francesco MINUTO. Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue[J]. Journal of Zhejiang University Science B, 2009, 10(5): 323-330.
@article{title="Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue",
author="Massimo GIUSTI, Mara DOLCINO, Lara VERA, Carla GHIARA, Francesca MASSARO, Laura FAZZUOLI, Diego FERONE, Michele MUSSAP, Francesco MINUTO",
journal="Journal of Zhejiang University Science B",
volume="10",
number="5",
pages="323-330",
year="2009",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0820372"
}
%0 Journal Article
%T Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue
%A Massimo GIUSTI
%A Mara DOLCINO
%A Lara VERA
%A Carla GHIARA
%A Francesca MASSARO
%A Laura FAZZUOLI
%A Diego FERONE
%A Michele MUSSAP
%A Francesco MINUTO
%J Journal of Zhejiang University SCIENCE B
%V 10
%N 5
%P 323-330
%@ 1673-1581
%D 2009
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820372
TY - JOUR
T1 - Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue
A1 - Massimo GIUSTI
A1 - Mara DOLCINO
A1 - Lara VERA
A1 - Carla GHIARA
A1 - Francesca MASSARO
A1 - Laura FAZZUOLI
A1 - Diego FERONE
A1 - Michele MUSSAP
A1 - Francesco MINUTO
J0 - Journal of Zhejiang University Science B
VL - 10
IS - 5
SP - 323
EP - 330
%@ 1673-1581
Y1 - 2009
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820372
Abstract: Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyperparathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45%, 30%, 17%, 4%, and 4% of cases, respectively. In 47% of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94% for FNAB and 71% for scintigraphy, while sensitivity was 83% and 69%, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.
[1] Abraham, D., Sharma, P.K., Bentz, J., Gault, P.M., Neumayer, L., McClain, D.A., 2007. Utility of ultrasound-guided fine-needle aspiration of parathyroid adenomas for localization before minimally invasive parathyroidectomy. Endocr. Pract., 13(4):333-337.
[2] Allendorf, J., Kim, L., Chabot, J., DiGiorgi, M., Spanknebel, K., LoGerfo, P., 2003. The impact of sestamibi scanning on the outcome of parathyroid surgery. J. Clin. Endocrinol. Metab., 88(7):3015-3018.
[3] Barczynski, M., Golkowski, F., Konturek, A., Buziak-Bereza, M., Cichon, S., Hubalewska-Dydejczyk, A., Huszno, B., Szybinski, Z., 2006. Technetium-99m-sestamibi subtraction scintigraphy vs ultrasonography combined with a rapid parathyroid hormone assay in parathyroid aspirates in preoperative localization of adenomas and in directing surgical approach. Clin. Endocrinol. (Oxf), 65(1): 106-113.
[4] Bergenfelz, A., Forsberg, L., Hederstrom, E., Ahren, B., 1991. Preoperative localization of enlarged parathyroid glands with ultrasonically guided fine needle aspiration for parathyroid hormone assay. Acta Radiol., 32(5):403-405.
[5] Bhansali, A., Masoodi, S.R., Bhadada, S., Mittal, B.R., Behra, A., Singh, P., 2006. Ultrasonogrphy in detection of single and multiple abnormal parathyroid glands in primary hyperparathyroidism: comparison with radionuclide scintigraphy and surgery. Clin. Endocrinol. (Oxf), 65(3): 340-345.
[6] Calva-Cerqueira, D., Smith, B.J., Hostetler, M.L., Lai, G., Menda, Y., O'Dorisio, T.M., Howe, Y.R., 2007. Minimally invasive parathyroidectomy and preoperative MIBI scan: correlation of gland weight and preoperative PTH. J. Am. Coll. Surg., 205(4 Suppl.):S38-S44.
[7] Doppman, J.L., Krudy, A.G., Marx, S.J., Saxe, A., Schneider, P., Norton, Y.A., Spiegel, A.M., Downs, R.W., Schaaf, M., Brennan, M.E., Schneider, A.B., Aurbach, G.D., 1983. Aspiration of enlarged parathyroid glands for parathyroid hormone assay. Radiology, 148(1):31-35.
[8] Erbil, Y., Barbaros, U., Salmaslioglu, A., Tunaci, M., Ozbey, N., Bozbora, A., Ozmarmagan, S., 2006. Values of parathyroid assay for preoperative sonographically guided parathyroid aspirates for minimally invasive parathyroidectomy. J. Clin. Ultrasound., 34(9):425-429.
[9] Erbil, Y., Salmaslioglu, A., Kabul, E., Issever, H., Tunaci, M., Adalet, I., Bozbora, A., Ozmarmagan, S., 2007. Use of preoperative parathyroid fine-needle asipiration and parathormone assay in primary hyperparathyroidism with concomitant thyroid nodules. Am. J. Surg., 193(6): 665-671.
[10] Grosso, I., Sargiotto, A., D'Amelio, P., Tamone, C., Gasparri, G., de Filippi, P.G., Picciotto, G., Isaia, G., 2007. Preoperative localization of parathyroid adenoma with sonography and 99mTc-sestamibi scintigraphy in primary hyperparathyroidism. J. Clin. Ultrasound., 35(4):186-190.
[11] Kendrick, M.L., Charboneau, J.W., Curlee, K.J., van Heerden, J.A., Farley, D.R., 2001. Risk of parathyromatosis after fine-needle aspiration. Am. Surg., 67(3):290-293.
[12] Kiblut, N.K., Cussac, J.F., Soudan, B., Farrell, S.G., Armstrong, J.A., Arnalsteen, L., Biechlin, A., Delattre, A.A., Proye, C.A., 2004. Fine needle aspiration and intraparathyroid intact parathyroid hormone measurement for reoperative parathyroid surgery. World J. Surg., 28(11): 1143-1147.
[13] Lumachi, F., Marzola, M.C., Zucchetta, P., Tregnaghi, A., Cecchin, D., Bui, F., 2003. Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy. Endocr. Relat. Cancer, 10(3):419-423.
[14] Marcocci, C., Mazzeo, S., Bruno-Bossio, G., Picone, A., Vignali, E., Ciampi, M., Vacava, P., Naccarato, A.G., Miccoli, P., Iacconi, P., Pinchera, A., 1998. Preoperative localization of suspicious parathyroid adenomas by assay of parathyroid hormone in needle aspirates. Eur. J. Endocrinol., 139(1):72-77.
[15] Masatsugu, T., Yamashita, H., Noguchi, S., Nishii, R., Watanabe, S., Uchino, S., Kuroki, S., Tanaka, M., 2005. Significant differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease. Surg. Today, 35(5):351-356.
[16] Maser, C., Donovan, P., Santos, F., Donabedian, R., Rinder, C., Scoutt, L., Udelman, R., 2006. Sonographically guided fine needle aspiration with rapid parathyroid hormone assay. Ann. Surg. Oncol., 13(12):1690-1695.
[17] Miccoli, P., Berti, P., 2001. Minimally invasive parathyroid surgery. Best Pract. Res. Clin. Endocrinol. Metab., 15(2):139-147.
[18] Mihai, R., Gleeson, F., Buley, I.D., Roskell, D.E., Sadler, G.P., 2006. Negative imaging studies for primary hyperparathyroidism and unavoidable: correlation of sestamibi and high-resolution ultrasound scanning with histological analysis in 150 patients. World J. Surg., 30(5):697-704.
[19] Rodgers, S.E., Lew, J.I., Salorzano, C.C., 2008. Primary hyperparathyroidism. Curr. Opin. Oncol., 20(1):52-58.
[20] Solbiati, L., Montali, G., Croce, F., Bellotti, E., Giangrande, A., Ravetto, C., 1983. Parathyroid tumors detected by fine-needle aspiration biopsy under ultrasonic guidance. Radiology, 148(3):793-797.
[21] Solbiati, L., Osti, V., Cova, L., Tonolini, M., 2001. Ultrasound of thyroid, parathyroid glands and neck lymph nodes. Eur. Radiol., 11(12):2411-2424.
[22] Zheng, Y.X., Xu, S.M., Wang, P., Chen, L., 2007. Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease. J. Zhejiang Univ. Sci. B, 8(9):626-631.
Open peer comments: Debate/Discuss/Question/Opinion
<1>