Tc-99m MIBI Negatif Primer Hiperparatiroidizm Olgularında Parathormon Yıkamanın Tanısal Değeri

Abstract

Aim: To determine the sensitivity and positive predictive value (PPV) of the measurement of parathormone (PTH) in fine needle aspiration (FNA) washout fluid in the preoperative localization of hyperfunctional parathyroid lesions. Methods: Medical records of patients diagnosed with primary hyperparathyroidism (PHPT) in our clinic between 2016-2020 washout were retrospectively evaluated. 36 patients with PHPT who underwent preoperative FNA-PTH washout procedure were included in the study. FNA-PTH washout was only performed in patients with negative technetium-99m methoxy isobutyl isonitrile /single photon emission computed tomography (Tc-99m MIBI/SPECT) imaging. It was accepted to be higher than plasma PTH level as positive cut-off value for PTH washout in determining parathyroid lesions. Sensitivity, PPV, false positive, false negative and diagnostic accuracy values of PTH washout were calculated. Results: PTH washout was false positivity in 2 cases, false negative in 1 case and true positive in 33 cases. In the discrimination of true parathyroid lesions, the sensitivity of PTH washout was calculated as 97.05%, specificity 100%, PPV 94.29% and diagnostic accuracy 91.67%. PTH washout levels correlated positively with plasma PTH and parathyroid lesion volume. Conclusion: The FNA-PTH washout is a safe and useful method to localise parathyroid lesions in PHPT patients with negative Tc-99m MIBI/SPECT imaging.