ECE2015 Eposter Presentations Calcium and Vitamin D metabolism (96 abstracts)
The diagnostic value of parathyroid hormone washout in primary hyperparathyroidism patients with negative or unequivocal 99mTc-MIBI results
Cevdet Aydin 1 , Sefika Burcak Polat 1 , Fatma Dilek Dellal 1 , Cafer Kaya 1 , Seyda Turkolmez 2 , Mehmet Kilic 3 , Reyhan Ersoy 1 & Bekir Cakir 1
1Endocrinology and Metabolism Department, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey; 2Nuclear Medicine Department, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey; 3General Surgery Department, Ataturk Education and Research Hospital, Yildirim Beyazit University, Ankara, Turkey.
Introduction: Primary hyperparathyroidism (pHPT) is a common endocrine disease mainly caused by single or multiple hyperfunctioning parathyroid lesions. In 2–7% of cases, surgery is not curative at first operation and reoperation is required. Ultrasonography and sestamibi scan are the most widely used methods for identification of the culprit parathyroid gland with the disadvantage of high false positives caused by other cervical pathologies. Herein we aimed to search the diagnostic value of measurement of parathyroid hormone (PTH) concentration in the needle washout of suspicious lesions suggestive for parathyroid adenoma with negative or unequivocal MIBI results.
Methods: Our endocrine database was searched retrospectively for the patients with PHPT who underwent PTH washout. There were 100 lesions of 70 patients. Among them, 21 lesions in 16 patients were operated and data of these lesions were analysed. All patients had at least one suspicious parathyroid lesion detected by ultrasonography and all patients were evaluated by 99mTc-MIBI.
Result: The mean age of the patients was 53.3±10.6 years with the majority of them being female (87.5%). The mean preoperative serum calcium level was 11.04±0.33 mg/dl. The median serum PTH level was 140 pg/ml (ranging from 55 to 371) and the median serum PTH washout level was 3316 pg/ml ranging from 13 to 5000. Preoperatively 99mTc-MIBI scan was negative or unequivocal in 15 of 21 operated lesions while it was positive in six. For the lesions that the MIBI failed to localise, the sensitivity of PTH washout was 91% and the specificity was 66%.
Conclusion: PTH washouts can contribute significantly in establishing the parathyroid nature of cervical lesions that has conflicting preoperative sestamibi results and also might help the surgeon to perform a more successful operation.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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