Intraoperative Parathyroid Hormone Testing Publications

UW Publication

Summary

Wild JL, Weigel T, Chen H. The need for intraoperative parathyroid hormone monitoring during radioguided parathyroidectomy via video-assisted thoracoscopy (VATS). Clinical Nuclear Medicine. 2006; 31:9-12.

Measuring the blood levels of parathyroid hormone during this patient's surgery alerted the surgeon that there was an aditional hyperfunctioning parathyroid.  This enabeled the team to remove the second adenoma immediately, and prevented the patient from undergoing a second surgery.

Weigel TL, Murphy J, Kabbani L, Ibele A, Chen H. Radioguided Thoracoscopic Mediastinal Parathroidectomy with Intraoperative PArathyroid Hormone Testing. Annals of Thoracic Surgery, 2005; 80:1262-1265.

Patients in this study had parathyroids located in the chest (mediastinum).  The standard location techniques of gamma probe and measurement of parathyroid hormone levels during surgery were successful in finding these abnormally placed parathryoids, resulting in a cure for all patients.

Chen H, Pruhs ZM, Starling JR, Mack E. Intraoperative Parathyroid Hormone Testing Improves Cure Rates in Patients Undergoing Minimally Invasive Parathyroidectomy. Surgery, 2005; 138:583-590.

Testing blood levels of PTH during surgery ensures that all overproducing parathyroids are located and removed.  This new technique results in a nearly 100% cure rate during surgery, and therefore eliminates the need for an additional surgery at a later time.

Chen H, Mack E, Starling JR. A Comprehensive Evaluation of Peri-operative Adjuncts during Minimally Invasive Parathyroidectomy: Which is Most Reliable? Ann Surg, 2005; 242:375-383.

This study compared 3 of the techniques used before and during surgery to successfully locate and remove the hyperfunctioning parathyroid: nuclear scan ("sestamibi-SPECT"), gamma probe, and intra-operative measurements of parathyroid hormone (ioPTH) in the blood.  It was determined that ioPTH has a 99.5% sensitivity in confirming that the correct parathyroid was removed.  The other two techniques have sensitivities of 81% and 88% respectively, and are currently used alongside ioPTH measurements to aid in location of the parathyroid.  Using these 3 techniques, a parathyroidectomy performed by a surgeon at the UW hospital has a cure rate of 98%.