Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

Massimo Giusti, Mara Dolcino, Lara Vera, Carla Ghiara, Francesca Massaro, Laura Fazzuoli, Diego Ferone, Michele Mussap, Francesco Minuto

Research output: Contribution to journalArticle

Abstract

Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyperparathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45%, 30%, 17%, 4%, and 4% of cases, respectively. In 47% of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94% for FNAB and 71% for scintigraphy, while sensitivity was 83% and 69%, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalJournal of Zhejiang University: Science B
Volume10
Issue number5
DOIs
Publication statusPublished - 2009

Fingerprint

parathyroid hormone
Biopsy
Needle Biopsy
Fine Needle Biopsy
Parathyroid Hormone
Washing
Needles
washing
biopsy
Tissue
scintigraphy
Ultrasonography
Radionuclide Imaging
Cytology
ultrasonography
Thyroid Gland
cell biology
Cell Biology
tissues
hyperparathyroidism

Keywords

  • Fine-needle aspiration biopsy (FNAB)
  • Nodular goitre
  • Parathyroid hormone (PTH)-FNAB
  • Primary hyperparathyroidism
  • Scintigraphy
  • Ultrasonography

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • veterinary(all)

Cite this

Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue. / Giusti, Massimo; Dolcino, Mara; Vera, Lara; Ghiara, Carla; Massaro, Francesca; Fazzuoli, Laura; Ferone, Diego; Mussap, Michele; Minuto, Francesco.

In: Journal of Zhejiang University: Science B, Vol. 10, No. 5, 2009, p. 323-330.

Research output: Contribution to journalArticle

Giusti, Massimo ; Dolcino, Mara ; Vera, Lara ; Ghiara, Carla ; Massaro, Francesca ; Fazzuoli, Laura ; Ferone, Diego ; Mussap, Michele ; Minuto, Francesco. / Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue. In: Journal of Zhejiang University: Science B. 2009 ; Vol. 10, No. 5. pp. 323-330.
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abstract = "Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyperparathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45{\%}, 30{\%}, 17{\%}, 4{\%}, and 4{\%} of cases, respectively. In 47{\%} of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94{\%} for FNAB and 71{\%} for scintigraphy, while sensitivity was 83{\%} and 69{\%}, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.",
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