TY - JOUR
T1 - Point-of-care rapid intraoperative parathyroid hormone assay of needle aspirates from parathyroid tissue
T2 - A substitute for frozen sections
AU - Farrag, Tarik
AU - Weinberger, Paul
AU - Seybt, Melanie
AU - Terris, David J.
PY - 2011/11
Y1 - 2011/11
N2 - Background: The intraoperative parathyroid hormone (IOPTH) assay is an important tool that facilitates targeted parathyroidectomy and may increase surgical cure rates. We sought to evaluate the utility of a point-of-care assay to distinguish parathyroid adenomas from nonparathyroid tissues, which can sometimes pose a challenge during parathyroidectomy and is commonly achieved with the use of frozen sections. We hypothesized that point-of-care rapid IOPTH assays of needle aspirates from suspected adenomas would be faster and equal in accuracy to frozen sections. Methods: Parathyroid and nonparathyroid lesions were excised, and the tissues were needle aspirated, diluted in saline, and submitted to a rapid IOPTH assay located in the operating room. Frozen sections were simultaneously sent for analysis. The time intervals to result availability were tracked and compared using a paired t test. Results: Point-of-care IOPTH assays of needle aspirates were available in a mean (±SD) of 11.6 ± 1.5 minutes compared to 18.7 ± 4.0 minutes for frozen sections (P =.005). The findings were concordant 100% of the time for both parathyroid (mean parathyroid hormone [PTH] > 3338.9 pg/mL) and parathyroid tissues (mean PTH = 8.7 pg/mL). Conclusion: Point-of-care IOPTH assay of needle aspirates is an accurate method of distinguishing parathyroid from nonparathyroid tissues. It is suggested that this would be particularly useful in instances where use of IOPTH is planned for assessment of a drop in serum PTH.
AB - Background: The intraoperative parathyroid hormone (IOPTH) assay is an important tool that facilitates targeted parathyroidectomy and may increase surgical cure rates. We sought to evaluate the utility of a point-of-care assay to distinguish parathyroid adenomas from nonparathyroid tissues, which can sometimes pose a challenge during parathyroidectomy and is commonly achieved with the use of frozen sections. We hypothesized that point-of-care rapid IOPTH assays of needle aspirates from suspected adenomas would be faster and equal in accuracy to frozen sections. Methods: Parathyroid and nonparathyroid lesions were excised, and the tissues were needle aspirated, diluted in saline, and submitted to a rapid IOPTH assay located in the operating room. Frozen sections were simultaneously sent for analysis. The time intervals to result availability were tracked and compared using a paired t test. Results: Point-of-care IOPTH assays of needle aspirates were available in a mean (±SD) of 11.6 ± 1.5 minutes compared to 18.7 ± 4.0 minutes for frozen sections (P =.005). The findings were concordant 100% of the time for both parathyroid (mean parathyroid hormone [PTH] > 3338.9 pg/mL) and parathyroid tissues (mean PTH = 8.7 pg/mL). Conclusion: Point-of-care IOPTH assay of needle aspirates is an accurate method of distinguishing parathyroid from nonparathyroid tissues. It is suggested that this would be particularly useful in instances where use of IOPTH is planned for assessment of a drop in serum PTH.
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U2 - 10.1016/j.amjoto.2010.11.013
DO - 10.1016/j.amjoto.2010.11.013
M3 - Article
C2 - 21315486
AN - SCOPUS:80055059390
SN - 0196-0709
VL - 32
SP - 574
EP - 577
JO - American Journal of Otolaryngology - Head and Neck Medicine and Surgery
JF - American Journal of Otolaryngology - Head and Neck Medicine and Surgery
IS - 6
ER -