Cervical ultrasound combined with parathyroid hormone assay prior to parathyroid exploration

Abstract

The purpose of this study was to analyse ultrasound (US) findings and US-guided fine needle aspirations (FNAs) for parathyroid hormone (PTH) in pre-operative evaluation prior to parathyroid exploration. Thirteen patients with primary hyperparathyroidism (pHTP) underwent cervical US combined with FNAs. Fourteen suspected lesions were aspirated and the patients were operated on. The US examinations were performed with a real-time scanner using a 7.5-MHz transducer and the direct contact method. The aspiration method was modified according to Doppman et al. (1983), the main differences being that US instead of CT-guidance was used and an immunoradiometric assay was performed for the direct quantitative determination of intact PTH instead of a mid-region specific radioimmunoassay. The freehand technique was employed, using needles with an outer diameter of 0.55–0.6 mm, and the aspirated material (1–2 drops of blood) was dissolved in 1 ml saline. Ice was used to freeze the sample immediately.