Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single‐centre retrospective cohort study

Canpolat, Asena Gökçay; Şahi̇n, Mustafa; Ediboglu, E. Durak; Erdoğan, Murat Faik; Güllü, Sevim; Demir, Özgür; Emral, Rıfat; Çorapçıoğlu, Demet

doi:10.1111/cen.13812

Cited by 16 publications

(15 citation statements)

References 23 publications

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“…The characteristics of the included articles are summarized in Table 1 (19,20,21,22,23,24,25,26,27). The papers were published between 1998 and 2018, had sample sizes ranging from 6 to 44 patients.…”

Section: Qualitative Analysis (Systematic Review)mentioning

confidence: 99%

“…FNA-PTH was performed with a 21-to 27-gauge needle, washed out with 0.5-1 mL of 0.9% saline or PTH-free serum. The result was considered as positive if higher than patient's serum PTH level at the time of sampling in four studies (19,21,24,25), two times this level in one (22); the remaining papers reported a cutoff ranging from 40 to 103 pg/mL (Table 2) (20,23,26,27). Overall, 222 lesions in 182 patients were evaluated.…”

Section: Qualitative Analysis (Systematic Review)mentioning

confidence: 99%

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Primary hyperparathyroidism with surgical indication and negative or equivocal scintigraphy: safety and reliability of PTH washout. A systematic review and meta-analysis

Castellana

Virili

Palermo

et al. 2019

European Journal of Endocrinology

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Objective Despite the improvements in ultrasound (US) and scintigraphy, 10–20% of patients with primary hyperparathyroidism (PHPT) still have discordant findings. We performed a systematic review and meta-analysis to assess the safety and the diagnostic performance of US-guided PTH washout (FNA-PTH) in patients with PHPT, a suspected parathyroid lesion on US but negative or equivocal scintigraphy. Methods The review was registered on PROSPERO (CRD42019124249). PubMed, Scopus, CENTRAL and Web of Science were searched until February 2019. Original articles reporting complications and diagnostic performance of FNA-PTH in biochemically and histopathologically diagnosed PHPT were selected. The risk of bias of included studies was assessed through QUADAS-2. Summary operating points were estimated using a random-effects model. Results Out of 2573 retrieved papers, nine cohort studies were included in the review. No major procedure-related complications were found. Pooled sensitivity was 95% (95% CI: 91–98; I 2: = 14%) and positive predictive value was 97% (95% CI: 93–100; I 2: = 39%). There were not enough data for specificity and negative predictive value to perform a meta-analysis. However, pooling results of all lesions, they were estimated to be 83 and 73%, respectively. Conclusions In patients with biochemically proven PHPT and discordant imaging, FNA-PTH was a safe and accurate procedure. In this specific setting of patients, FNA-PTH could be used as a rule-in test for minimally invasive parathyroidectomy.

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Section: Qualitative Analysis (Systematic Review)mentioning

confidence: 99%

Section: Qualitative Analysis (Systematic Review)mentioning

confidence: 99%

Primary hyperparathyroidism with surgical indication and negative or equivocal scintigraphy: safety and reliability of PTH washout. A systematic review and meta-analysis

Castellana

Virili

Palermo

et al. 2019

European Journal of Endocrinology

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“…found that the PTH washout/plasma PTH ratio over 3.05 had a specificity of 89% [17]. This data suggests that when higher PTH washout / plasma PTH ratio is accepted as positive cut-off value, it may increase false negative results.…”

Section: Discussionmentioning

confidence: 86%

“…There are studies suggesting different positive cut-off values for PTH washout. Gokcay et al found sensitivity at 90.3% and specificity at 88.9% in determining parathyroid lesion when they received 436.5 pg/mL as the positive cut-off value for PTH washout [17]. Kiblud et al showed that a PTH washout result of more than 1 000 pg/mL had sensitivity of 75% and PPV of 74% in the verification of parathyroid tissue [18].…”

Section: Discussionmentioning

confidence: 99%

Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

Korkmaz

2021

Acta Medica Alanya

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Amaç: Hiperfonksiyon gösteren paratiroid lezyonlarının preoperatif lokalizasyonun-da ince iğne aspirasyonu (İİA) yıkama sıvısında parathormon (PTH) ölçümünün du-yarlılık ve pozitif prediktif değer (PPD)'ini belirlemek. Yöntem: 2016-2020 yılları arasında kliniğimizde primer hiperparatiroidi (PHPT) tanısı alan hastaların tıbbi kayıtları retrospektif olarak inceledik. Operasyon öncesi İİA-PTH yıkama prosedürü uygulanan 36 PHPT hastası çalışmaya alındı. İİA-PTH yıkama, sadece teknesyum-99m metoksi-isobutil-isonitril / tek foton emisyonlu bilgisayarlı to-mografi (Tc-99m MIBI/SPECT) negatif hastalarda yapıldı. Serum PTH seviyesinden daha yüksek PTH yıkama seviyeleri, pozitif kesme değeri olarak tanımlandı. İİA-PTH yıkama prosedürünün duyarlılık, PPD, yanlış pozitif, yanlış negatif ve tanısal doğruluk değerleri hesaplandı. Bulgular: PTH yıkama 2 olguda yanlış pozitif, 1 olguda yanlış negatif ve 33 olguda gerçek pozitifti. Gerçek paratiroid lezyonların ayırt edilmesinde PTH yıkamanın du-yarlılığı %97.05, pozitif prediktif değeri %94.29 ve tanısal doğruluğu %91.67 olarak hesaplandı. PTH yıkanma seviyeleri, serum PTH ve paratiroid lezyon hacmi ile pozitif koreleydi (sırasıyla, r= 0.347, p= 0.041 ve r=0.356, p= 0.036). Tüm hastalar İİA-PTH yıkama işlemini iyi tolere etti ve sonrasında herhangi bir komplikasyon gelişmedi. Sonuç: İİA-PTH yıkaması, Tc-99m MIBI/SPECT negatif PHPT hastalarında paratiroid lezyonlarını lokalize etmek için güvenli ve kullanışlı bir yöntemdir.

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“…In the recently published article of Gökçay Canpolat et al, “Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single‐centre retrospective cohort study …”

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confidence: 99%

Corrigendum

2019

Clinical Endocrinology

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Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: A single‐centre retrospective cohort study

Cited by 16 publications

References 23 publications

Primary hyperparathyroidism with surgical indication and negative or equivocal scintigraphy: safety and reliability of PTH washout. A systematic review and meta-analysis

Primary hyperparathyroidism with surgical indication and negative or equivocal scintigraphy: safety and reliability of PTH washout. A systematic review and meta-analysis

Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

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