scholarly journals Intraoperative parathyroid hormone as an indicator for parathyroid gland preservation in thyroid surgery

2011 ◽  
Author(s):  
WF Ezzat ◽  
H Fathey ◽  
S Fawaz ◽  
A El-Ashri ◽  
T Youssef ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Parathyroid Gland ◽  
Thyroid Surgery ◽  
Intraoperative Parathyroid Hormone

Minimally Invasive Parathyroid Surgery, The Norman 20% Rule: Is It Valid?

2011 ◽  
Vol 77 (4) ◽  
pp. 484-487 ◽  
Author(s):  
Amy R. Quillo ◽  
Jeffery M. Bumpous ◽  
Richard E. Goldstein ◽  
Muffin M. Fleming ◽  
Ccrp ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Parathyroid Gland ◽  
Ex Vivo ◽  
Frozen Section ◽  
Postoperative Management ◽  
Average Percentage ◽  
Parathyroid Hormone Monitoring ◽  
Intraoperative Parathyroid Hormone

The 20 per cent rule proposed by Norman established a guideline using radioactivity in the minimally invasive radioguided parathyroidectomy (MIRP) technique to localize and confirm removal of an abnormal parathyroid gland in patients with primary hyperparathyroidism. If radioactivity in the resected gland was at least 20 per cent of excision site/background radioactivity, the 20 per cent rule was satisfied. Patients meeting these criteria underwent unilateral MIRP without intraoperative parathyroid hormone assay or intraoperative frozen section. The study aim was to independently evaluate the 20 per cent rule in MIRP patients with primary hyperparathyroidism. Using the University of Louisville Parathyroid Database from January 1, 1999 to December 31, 2007, 216 MIRP patients with complete radioguided and postoperative management data were identified. The average percentage of ex vivo parathyroid gland radioactivity compared with excision site/background radioactivity was 107 per cent with a range from 14 to 388 per cent. For 99 per cent (196/198) radioactivity recorded from the excised gland was at least 20 per cent of radioactivity recorded from the excision site. Normocalcemia was documented in 98.5 per cent (195/198) at 12 month follow-up. Our data supports the 20 per cent rule in that in 99 per cent of MIRP patients the resected gland radioactivity was at least 20 per cent of excision site radioactivity allowing localization and confirmation of an overactive gland without intraoperative parathyroid hormone monitoring or tissue analysis.

Correlation of Intraoperative Parathyroid Hormone Levels With Parathyroid Gland Size

2007 ◽  
Vol 117 (11) ◽  
pp. 1957-1960 ◽  
Author(s):  
William H. Moretz ◽  
Tammara L. Watts ◽  
Frank W. Virgin ◽  
Edward Chin ◽  
Christine G. Gourin ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Parathyroid Gland ◽  
Hormone Levels ◽  
Gland Size ◽  
Intraoperative Parathyroid Hormone

scholarly journals Evaluation of Autofluorescence in Identifying Parathyroid Glands by Measuring Parathyroid Hormone in Fine-Needle Biopsy Washings

2021 ◽  
Author(s):  
Zhen liu ◽  
Run-sheng Ma ◽  
Jun-li Jia ◽  
Tao Wang ◽  
Dao-hong Zuo ◽  
...  
Keyword(s):  
Lymph Node ◽  
Parathyroid Hormone ◽  
Lymph Nodes ◽  
Thyroid Surgery ◽  
Near Infrared ◽  
Parathyroid Glands ◽  
Autofluorescence Imaging ◽  
Node Dissection ◽  
Fine Needle ◽  
Intraoperative Parathyroid Hormone

Abstract Background: Near-infrared autofluorescence imaging has potentially great value for assisting endocrine surgeons in identifying parathyroid glands and may dramatically change the surgical strategy of endocrine surgeons in thyroid surgery. This study is designed to objectively evaluate the role of near-infrared autofluorescence imaging in identifying parathyroid glands during thyroid surgery by measuring intraoperative parathyroid hormone in fine-needle aspiration biopsy washings.Methods: A case series study was conducted at a tertiary referral teaching hospital in China from September 2019 to April 2020. Patients undergoing total thyroidectomy with or without neck lymph node dissection were consecutively included. The surgeon used near-infrared autofluorescence imaging to identify parathyroid glands during thyroid surgery and confirmed suspicious parathyroid tissues by measuring their intraoperative parathyroid hormone. Nanocarbon was injected into the thyroid gland if the thyroid autofluorescence intensity was too strong. The sensitivity and accuracy of near-infrared autofluorescence imaging and vision for identifying parathyroid glands, and the difference in autofluorescence intensity in various tissues were the main outcomes.RESULTS: Overall, 238 patients completed the trial. Based on the pathological and aIOPTH results, the sensitivity of near-infrared autofluorescence imaging for detecting parathyroid glands（568 of 596 parathyroid glands; 95.30%）was significantly higher than that of vision（517 of 596 parathyroid glands; 86.74%, P<.001). The accuracy of near-infrared autofluorescence imaging (764 of 841 tissues; 90.84%) was significantly higher than that of vision (567 of 841 tissues; 67.42%, P<.001) when the evaluations of certain tissues were inconsistent. There was a significant difference between the autofluorescence intensity of the parathyroid glands and that of the lymph nodes (74.19 ± 17.82 vs 33.97 ± 10.64, P<.001).CONCLUSIONS: The use of near-infrared autofluorescence imaging, along with intraoperative parathyroid hormone and nanocarbon for the identification of parathyroid glands in thyroid surgery may increase the number of confirmed parathyroid glands. Using near-infrared autofluorescence imaging can effectively distinguish lymph nodes and parathyroid glands during lymph node dissection.

Primary hyperparathyroidism after thyroid surgery and autotransplantion of parathyroid gland

2018 ◽  
Author(s):  
Bernardo Marques ◽  
Raquel Martins ◽  
Joana Couto ◽  
Jacinta Santos ◽  
Teresa Martins ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Thyroid Surgery
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