Sonographically Guided Fine Needle Aspiration with Rapid Parathyroid Hormone Assay

Maser, Christina; Donovan, Patricia; Santos, F. O.; Donabedian, R. K.; Rinder, Christine S.; Scoutt, Leslie M.; Udelsman, Robert

doi:10.1245/s10434-006-9180-z

Cited by 72 publications

(67 citation statements)

References 10 publications

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“…No adverse events were reported in our study or in that of Erbil et al(2006;. Maser et al(2006), who made 2~9 passes, reported 1 in situ infection, while Abraham et al(2007) reported 1 syncope and Marcocci et al(1998) 1 local haemorrhage. So far, more than 12 months after successful surgery, no recurrence of hyperparathyroidism as an expression of FNAB parathyromatosis has been noted in our series of patients; similar results were reported by Marcocci et al(1998).…”

Section: Resultsmentioning

confidence: 43%

“…An intra-operative PTH-FNAB value >1000 ng/L has been reported in 88% of patients with parathyroid adenoma. Maser et al(2006) reported that a PTH-FNAB value >1000 ng/L unequivocally indicates sampling in parathyroid tissue. In our series, only 38% of patients showed PTH-FNAB values >1000 ng/L.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, Marcocci et al(1998) regarded a PTH-FNAB >50 ng/L as positive for sampling in parathyroid tissue; considering dilution, this value could correspond to a PTH-FNAB value >1000 ng/L. Moreover, Maser et al(2006) considered only PTH-FNAB <45 mg/L to be inadequate in localizing PHP. In addition, our study shows that contamination of the needle with thyroid material is rather frequent when the target of FNAB is within or adjacent to the thyroid or posterior to the thyroid lobe.…”

Section: Resultsmentioning

confidence: 99%

“…Fine-needle aspiration biopsy (FNAB) of suspected parathyroid tissue and PTH assay on the needle wash-out after preparation of cytological specimens are further methods of localizing parathyroid adenomas. In 1983 this procedure was described by Doppman et al(1983); since then, several reports on US-guided PTH-FNAB have been published (Abraham et al, 2007;Barczynski et al, 2006;Erbil et al, 2006;Kiblut et al, 2004;Marcocci et al, 1998;Maser et al, 2006). This approach enables sonographic, cytological and biochemical results to be combined in order to localize parathyroid tissue with greater certainty.…”

Section: Introductionmentioning

confidence: 99%

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Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

Giusti¹,

Dolcino²,

Vera³

et al. 2009

J. Zhejiang Univ. Sci. B

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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.

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Section: Resultsmentioning

confidence: 43%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

Giusti¹,

Dolcino²,

Vera³

et al. 2009

J. Zhejiang Univ. Sci. B

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“…However, it is possible to determine PTH in the material aspirated by means of FNAB. The published reports on this method are encouraging so far [6,8,9,[15][16][17][18][19][20][21][22][23][24][25]. But only in a few studies has the influence of co-existing nodular goitre on the discussed method been analysed [6,8,24].…”

Section: Introductionmentioning

confidence: 99%

Przydatność oznaczania stężenia PTH w popłuczynach z igły do biopsji aspiracyjnej cienkoigłowej w identyfikowaniu patologicznych przytarczyc — analiza czynników wpływających na skuteczność tej metody

Popowicz¹,

Klencki²,

Sporny³

et al. 2014

Endokrynologia Polska

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Usefulness of PTH measurements in FNAB washouts in the identification of pathological parathyroids -analysis of the factors that influence the effectiveness of this methodPrzydatność oznaczania stężenia PTH w popłuczynach z igły do biopsji aspiracyjnej cienkoigłowej w identyfikowaniu patologicznych przytarczyc -analiza czynników wpływających na skuteczność tej metody AbstractIntroduction: The aim of this investigation was to assess the usefulness of the measurement of PTH concentration in the material obtained during FNAB (PTH-FNAB) in the identification of pathological parathyroids in patients with frequently coexisting thyroid abnormalities (nodular goitre, chronic thyroiditis, previous thyroidectomy). Additionally, the influence of the size of goitre, parathyroid localisation and size on the results of PTH-FNAB measurement was examined. Material and methods: Fifty patients with primary hyperparathyroidism and sonographically detected focal lesion that was suggestive of parathyroid gland were included in this study. PTH-FNAB results were correlated with the outcome of routine cytological examination and biochemical indices of hyperparathyroidism, SPECT-CT (33 patients) and histopathological examination (20 patients). Results: Positive PTH-FNAB was observed in 80% of patients, and in more than 70% of persons with non-diagnostic smears or smears 'contaminated' with thyroid follicular cells. In the group of operated patients, sensitivity of PTH-FNAB (95.0%) was higher than SPECT-CT (64.3%, p < 0.05). Presence of nodular goitre and/or chronic thyroiditis exerts a two times stronger negative effect on percentage of negative results of SPECT-CT than of PTH-FNAB. On the other hand, lower frequency of positive PTH-FNAB but not SPECT-CT was observed when the thickness of the thyroid was ≥ 20 mm (50% v. 87.5%, p < 0.05) and when the thickness of a lesion suspected of parathyroid pathology was £ 5 mm (66.7% v. 93.3%, p < 0.05). Conclusions: In patients with thyroid abnormalities, PTH-FNAB measurements show advantages over routine biopsy and SPECT-CT in the identification of typically located pathological parathyroids. (Endokrynol Pol 2014; 65 (1): 25-32)

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Parathyroid fine‐needle aspiration cytology in the evaluation of parathyroid adenoma: Cytologic findings from 53 patients

Agarwal

Bentz

Hungerford

et al. 2009

Diagnostic Cytopathology

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This study was designed to assess the utility of fine-needle aspiration cytology (FNAC) in the preoperative localization of parathyroid adenoma (PA). Fifty-seven samples from fifty-three cases of PA (four patients had bilateral disease) were obtained by ultrasound (US)-guided fine-needle aspiration. Parathyroid hormone (PTH) estimation was performed on the supernatant of the aspirated fluid on all cases. Subsequently, all of them underwent cytologic evaluation. The cytology slides were evaluated using the following criteria: Cellularity, architectural patterns, bare nuclei in the background, nuclear morphology, and background features (colloid-like material or macrophages). Parathyroid cells were seen in 23 samples (40.4%). The cellularity of the smears was insufficient for interpretation in 16 samples (28.1%); and thyroid follicles and colloid were seen in 18 samples (31.5%). Majority of the samples with parathyroid cells showed moderate cellularity with monomorphous round to slightly oval cells predominantly arranged in loose two-dimensional clusters with occasional papillary fragments. Majority of them exhibited a stippled nuclear chromatin. No significant pleomorphism, mitotic activity, or prominent nucleoli were observed. Most samples showed bare nuclei in the background. In conclusion, US-guided FNAC has its limitations because of low sensitivity in primary localization of the parathyroid adenoma in cases of primary hyperparathyroidism and is not a useful mode of investigation in cases of PA.

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Sonographically Guided Fine Needle Aspiration with Rapid Parathyroid Hormone Assay

Abstract: The use of rapid PTH assay can be effectively utilized for localization of parathyroid tissue in remedial parathyroid surgery. Confirmation of localization markedly improves subsequent surgery and allows selective use of minimally invasive techniques.

Cited by 72 publications

References 10 publications

Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

Przydatność oznaczania stężenia PTH w popłuczynach z igły do biopsji aspiracyjnej cienkoigłowej w identyfikowaniu patologicznych przytarczyc — analiza czynników wpływających na skuteczność tej metody

Parathyroid fine‐needle aspiration cytology in the evaluation of parathyroid adenoma: Cytologic findings from 53 patients

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