Risks and Benefits of Parathyroid Fine-Needle Aspiration with Parathyroid Hormone Washout

Bancos, Irina; Grant, Clive S.; Nadeem, Sarah; Stan, Marius N.; Reading, Carl C.; Sebo, Thomas J.; Algeciras‐Schimnich, Alicia; Singh, Ravinder J.; Dean, Diana S.

doi:10.4158/ep11148.or

Cited by 76 publications

(79 citation statements)

References 21 publications

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“…In the presented study, the routine FNAB allowed us to diagnose parathyroid tissue in 30% of cases. That value is similar to data reported by Bancos et al [20] -31% -and is higher than that showed by Giusti et al [8] -17%. The relatively high percentage of non-diagnostic Comparison of the thyroid size, the size of focal lesion suggestive of pathological parathyroid, and …”

Section: Discussionsupporting

confidence: 91%

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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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Section: Discussionsupporting

confidence: 91%

“…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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“…Initially, Doppman et al [54] reported seven cases of enlarged parathyroids with measurement of both PTH and Tg in washout (Table 3). Later, several studies demonstrated the relevance to measure FNA-PTH to localize parathyroid adenomas [14,15,[48][49][50][51][52][53][55][56][57][58][59][60][61][62][63][64][65][66][67]. In these papers, FNA-PTH achieved a sensitivity ranging from 70% to 100% and a specificity from 75% to 100%.…”

Section: Measurement Of Pth In Fna Fluids From Suspicious Hyperplastimentioning

confidence: 99%

“…Regarding the cutoff for FNA-PTH, no significant data have been published; thus, there is no consensus on reference range and their upper reference limit. Several proposals have been reported, ranging from 20 L [48] to 1000 ng/L [50]; some authors, to simplify the matter, have suggested considering positive any FNA-PTH value higher than the respective serum PTH concentration [51,53,60,64,65,67]. To avoid misclassification due to circadian and seasonal rhythms and to physical exercise [69], which can influence serum PTH concentrations, and blood contamination which can potentially affect FNA-PTH levels, we suggest as positive cutoff the FNA-PTH/serum PTH ratio ≥ 2 (Table 6).…”

Section: Measurement Of Pth In Fna Fluids From Suspicious Hyperplastimentioning

confidence: 99%

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Trimboli

D’Aurizio

Tozzoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Different imaging tools, circulating endocrine markers, and fine-needle aspiration (FNA) cytology are of great importance in the diagnosis and follow-up of different thyroid and parathyroid diseases. Sometimes, however, they are conflicting or inconclusive: interestingly, measuring endocrine markers (i.e. thyroglobulin, calcitonin, parathyroid hormone) in fluids from FNA proved to be a very useful complementary diagnostic tool in such cases. The determination of endocrine markers in fluids other than serum/ plasma has been developed in the last years. Although studies have reported overall satisfactory results, a good standardization of procedures has not yet been reached, and further efforts should be made in order to better define preanalytical, analytical, and post-analytical aspects. Here we reviewed critically the literature on the measurement of FNA endocrine markers, focusing on laboratory issues, such as preparation of the sample, choice of solution, and technical features of determination of these markers. Indeed, information for use of FNA-Tg, FNA-CT, and FNA-PTH in clinical practice was also provided.

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“…This procedure has a sensitivity and specificity of 91%-100%. The main limitation of parathyroid FNA with PTH washout are is its dependence on identification of a suspicious lesion by USG or CT and the number of false negative results (20).…”

Section: Parathyroid Fine-needle Aspiration (Fna) With Parathyroid Homentioning

confidence: 99%

Primary hyperparathyroidism – a diagnostic approach

Pathmanathan

Somasundaram

2012

Sri Lanka J. Diabetes Endocrinol. Metab.

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Primary hyperparathyroidism (PHPT) is characterized by the autonomous production of parathyroid hormone (PTH), in which there is hypercalcemia or normal-high serum calcium levels, in the presence of elevated or inappropriately normal serum PTH concentrations. Diagnosis of PHPT is biochemical. Advances in imaging technology, intraoperative parathyroid hormone measurement, and surgical technique now allow parathyroidectomy to be performed using a focused approach without the absolute need of a fourgland exploration. This brief review summarizes the various diagnostic modalities available for successful preoperative localization and management of the modern day PHPT patient.

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Risks and Benefits of Parathyroid Fine-Needle Aspiration with Parathyroid Hormone Washout

Cited by 76 publications

References 21 publications

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

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

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Primary hyperparathyroidism – a diagnostic approach

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