The number of needle passes affects the accuracy of parathyroid hormone assay with intraoperative parathyroid aspiration

• Published in: The American journal of surgery Vol. 200; no. 6; pp. 701 - 706
• Main Authors: Guerrero, Marlon A., M.D, Suh, Insoo, M.D, Vriens, Menno R., M.D, Shen, Wen T., M.D, Gosnell, Jessica, M.D, Kebebew, Electron, M.D, Clark, Orlo H., M.D, Duh, Quan-Yang, M.D
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2010; Elsevier; Elsevier Limited
• Subjects: Accuracy; Aspiration technique; Biological and medical sciences; Biopsy, Needle - methods; Data processing; Endocrine system; Endocrinopathies; Female; General aspects; Glands; Hormones; Humans; Hyperparathyroidism; Hyperparathyroidism, Primary - surgery; Intraoperative; Intraoperative Period; Laboratories; Male; Medical sciences; Middle Aged; Needle passes; Needles; Nodules; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Parathyroid; Parathyroid aspiration; Parathyroid gland; Parathyroid Glands - chemistry; Parathyroid hormone; Parathyroid Hormone - analysis; Parathyroid hormone assay; Parathyroidectomy; Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases); Patients; Primary hyperparathyroidism; Reproducibility of Results; Studies; Surgery; Thyroid gland; Tumors; Ultrasonic imaging; Parathyroid aspiration; Intraoperative; Primary hyperparathyroidism; Parathyroid hormone assay; Needle passes; Aspiration technique; Endocrinopathy; Aspiration; Peptide hormone; Medicine; Accuracy; Treatment; Number; Parathyroid diseases; Parathyroid hormone; Surgery; Needle; Primary; Parathyroid glands; Hormonal investigation; Technique; Hyperparathyroidism
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2010.06.012

Abstract Introduction Intraoperative aspiration of a nodule and parathyroid hormone (PTH) assay has been shown to accurately confirm parathyroid tissue. However, the reported aspiration technique varies in the literature. We sought to determine if the number of passes affected the accuracy of PTH analysis. Methods A prospective analysis was performed on 25 consecutive patients who underwent a parathyroidectomy for primary hyperparathyroidism. The excised parathyroid gland was aspirated using 1, 3, and 5 passes. The data were analyzed using the Wilcoxon rank, chi-square, and Fisher exact tests to calculate the 2-tailed P value. Results Of the 26 glands aspirated, the mean PTH value varied with the number of passes, 2,073 pg/mL for 1 pass, 2,347 for 3 passes, and 2,695 for 5 passes ( P = .02). Accuracy was dependent on the number of passes, with 5 passes ( P = .018) having less PTH variation than 1 or 3 passes. Conclusions Aspiration of nodules to determine the PTH level helps confirm the presence of parathyroid tissue. The number of needle passes affects the accuracy of the PTH level, with 5 passes being the optimal number of passes to attain no false-negative results.