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• W2041569491 abstract "PurposeTo determine the utility of pre-operative venous sampling for PTH in symptomatic hyperparathyroidism.Materials and MethodsAn 8-year audit (2005-2012) of the Medical Imaging database at a single tertiary care institution was performed, using the key words parathyroid, venous and sampling. Cases of parathyroid venous sampling were extracted. The procedure records, clinical/biochemical records, PTH sampling results, operative findings, and pathology results were reviewed. Results of venous sampling were compared with operative and pathology findings when available. Results were evaluated to determine the utility of pre-operative venous sampling for PTH.ResultsVenous sampling for PTH was performed on 93 occasions in 86 patients. Results of operative pathology are available on 62 cases (no surgery N = 15; lost to follow-up N = 16). In these 62, hypersecretion of PTH was identified from a single vein or region in 48 studies. 45/48 were confirmed by pathology (true positive), and 3/48 were not (false positive). Of 14 non-localizing studies, 12 had positive lesions at surgery (false negative) and 2 did not (true negative). Sensitivity was 79% (true positive rate) and specificity was 40% (true negative rate). Accuracy was 76%, Positive predictive value was 94% and negative predictive value was 14%. However, since many patients with negative localization do not undergo surgery, results may be biased by the small numbers of confirmed results, giving an unreliable specificity.ConclusionIn symptomatic hyperparathyroidism, pre-operative venous sampling for PTH is useful for localization of hypersecreting parathyroid tissue when a site of hypersecretion is found, but may not be particularly useful for exclusion of a hypersecreting focus when no venous hypersecretion is found. Table 1 To determine the utility of pre-operative venous sampling for PTH in symptomatic hyperparathyroidism. An 8-year audit (2005-2012) of the Medical Imaging database at a single tertiary care institution was performed, using the key words parathyroid, venous and sampling. Cases of parathyroid venous sampling were extracted. The procedure records, clinical/biochemical records, PTH sampling results, operative findings, and pathology results were reviewed. Results of venous sampling were compared with operative and pathology findings when available. Results were evaluated to determine the utility of pre-operative venous sampling for PTH. Venous sampling for PTH was performed on 93 occasions in 86 patients. Results of operative pathology are available on 62 cases (no surgery N = 15; lost to follow-up N = 16). In these 62, hypersecretion of PTH was identified from a single vein or region in 48 studies. 45/48 were confirmed by pathology (true positive), and 3/48 were not (false positive). Of 14 non-localizing studies, 12 had positive lesions at surgery (false negative) and 2 did not (true negative). Sensitivity was 79% (true positive rate) and specificity was 40% (true negative rate). Accuracy was 76%, Positive predictive value was 94% and negative predictive value was 14%. However, since many patients with negative localization do not undergo surgery, results may be biased by the small numbers of confirmed results, giving an unreliable specificity. In symptomatic hyperparathyroidism, pre-operative venous sampling for PTH is useful for localization of hypersecreting parathyroid tissue when a site of hypersecretion is found, but may not be particularly useful for exclusion of a hypersecreting focus when no venous hypersecretion is found. Table 1" @default.
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• W2041569491 date "2013-04-01" @default.
• W2041569491 modified "2023-09-27" @default.
• W2041569491 title "Symptomatic hyperparathyroidism: the utility of venous sampling for parathyroid hormone (PTH) for localization of hypersecreting parathyroid tissue" @default.
• W2041569491 doi "https://doi.org/10.1016/j.jvir.2013.01.371" @default.
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