Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization

Antonia E. Stephen, Kresimira Milas, Carolyn N. Garner, Kristen E. Wagner, Allan E. Siperstein, Andrew Saxe, Carmen Solorzano, Christopher R. Mchenry, Scott Wilhelm

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background. This study investigates the utility of ultrasound guided parathyroid fine needle aspiration (FNA) as a localizing technique in patients with hyperparathyroidism (HPT) undergoing re-operative neck surgery or with unusually appearing or ectopically located glands. Methods. Selected patients with HPT underwent surgeon-performed FNA with ultrasound guidance. Aspirate contents were sent for cytology and parathyroid hormone (PTH) levels. All patients subsequently underwent parathyroid exploration. Results. 54 patients underwent 57 ultrasound guided parathyroid biopsies. Indications for FNA included prior parathyroid (n = 29), thyroid (n = 11), or other neck surgery (n = 2), or unusual parathyroid appearance or location (n = 12). A true positive was defined as a site where the PTH aspirate was >40 pg/mL and a hypercellular gland was removed at surgery. Based on this, there were 44 true positives, 10 true negatives, and 3 false negatives; there were no false positives. The median PTH level in positive aspirates was 11,665 pg/mL. Cytology was primarily helpful in excluding other diagnoses. Conclusion. Ultrasound guided FNA is a highly specific localization test for parathyroid tumors. This procedure can be successfully performed by surgeons in the office setting and is extremely valuable for directing parathyroid exploration in challenging cases. We recommend incorporating ultrasound and FNA as a pre-operative localization strategy for selected patients with HPT.

Original languageEnglish (US)
Pages (from-to)1143-1151
Number of pages9
JournalSurgery
Volume138
Issue number6
DOIs
StatePublished - Dec 2005
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Hyperparathyroidism
Parathyroid Hormone
Cell Biology
Neck
Thyroid Gland
Surgeons
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Stephen, A. E., Milas, K., Garner, C. N., Wagner, K. E., Siperstein, A. E., Saxe, A., ... Wilhelm, S. (2005). Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization. Surgery, 138(6), 1143-1151. https://doi.org/10.1016/j.surg.2005.08.030

Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization. / Stephen, Antonia E.; Milas, Kresimira; Garner, Carolyn N.; Wagner, Kristen E.; Siperstein, Allan E.; Saxe, Andrew; Solorzano, Carmen; Mchenry, Christopher R.; Wilhelm, Scott.

In: Surgery, Vol. 138, No. 6, 12.2005, p. 1143-1151.

Research output: Contribution to journalArticle

Stephen, AE, Milas, K, Garner, CN, Wagner, KE, Siperstein, AE, Saxe, A, Solorzano, C, Mchenry, CR & Wilhelm, S 2005, 'Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization', Surgery, vol. 138, no. 6, pp. 1143-1151. https://doi.org/10.1016/j.surg.2005.08.030
Stephen, Antonia E. ; Milas, Kresimira ; Garner, Carolyn N. ; Wagner, Kristen E. ; Siperstein, Allan E. ; Saxe, Andrew ; Solorzano, Carmen ; Mchenry, Christopher R. ; Wilhelm, Scott. / Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization. In: Surgery. 2005 ; Vol. 138, No. 6. pp. 1143-1151.
@article{23894f3c0f4d40e2a87b73fb8c199124,
title = "Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization",
abstract = "Background. This study investigates the utility of ultrasound guided parathyroid fine needle aspiration (FNA) as a localizing technique in patients with hyperparathyroidism (HPT) undergoing re-operative neck surgery or with unusually appearing or ectopically located glands. Methods. Selected patients with HPT underwent surgeon-performed FNA with ultrasound guidance. Aspirate contents were sent for cytology and parathyroid hormone (PTH) levels. All patients subsequently underwent parathyroid exploration. Results. 54 patients underwent 57 ultrasound guided parathyroid biopsies. Indications for FNA included prior parathyroid (n = 29), thyroid (n = 11), or other neck surgery (n = 2), or unusual parathyroid appearance or location (n = 12). A true positive was defined as a site where the PTH aspirate was >40 pg/mL and a hypercellular gland was removed at surgery. Based on this, there were 44 true positives, 10 true negatives, and 3 false negatives; there were no false positives. The median PTH level in positive aspirates was 11,665 pg/mL. Cytology was primarily helpful in excluding other diagnoses. Conclusion. Ultrasound guided FNA is a highly specific localization test for parathyroid tumors. This procedure can be successfully performed by surgeons in the office setting and is extremely valuable for directing parathyroid exploration in challenging cases. We recommend incorporating ultrasound and FNA as a pre-operative localization strategy for selected patients with HPT.",
author = "Stephen, {Antonia E.} and Kresimira Milas and Garner, {Carolyn N.} and Wagner, {Kristen E.} and Siperstein, {Allan E.} and Andrew Saxe and Carmen Solorzano and Mchenry, {Christopher R.} and Scott Wilhelm",
year = "2005",
month = "12",
doi = "10.1016/j.surg.2005.08.030",
language = "English (US)",
volume = "138",
pages = "1143--1151",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Use of surgeon-performed office ultrasound and parathyroid fine needle aspiration for complex parathyroid localization

AU - Stephen, Antonia E.

AU - Milas, Kresimira

AU - Garner, Carolyn N.

AU - Wagner, Kristen E.

AU - Siperstein, Allan E.

AU - Saxe, Andrew

AU - Solorzano, Carmen

AU - Mchenry, Christopher R.

AU - Wilhelm, Scott

PY - 2005/12

Y1 - 2005/12

N2 - Background. This study investigates the utility of ultrasound guided parathyroid fine needle aspiration (FNA) as a localizing technique in patients with hyperparathyroidism (HPT) undergoing re-operative neck surgery or with unusually appearing or ectopically located glands. Methods. Selected patients with HPT underwent surgeon-performed FNA with ultrasound guidance. Aspirate contents were sent for cytology and parathyroid hormone (PTH) levels. All patients subsequently underwent parathyroid exploration. Results. 54 patients underwent 57 ultrasound guided parathyroid biopsies. Indications for FNA included prior parathyroid (n = 29), thyroid (n = 11), or other neck surgery (n = 2), or unusual parathyroid appearance or location (n = 12). A true positive was defined as a site where the PTH aspirate was >40 pg/mL and a hypercellular gland was removed at surgery. Based on this, there were 44 true positives, 10 true negatives, and 3 false negatives; there were no false positives. The median PTH level in positive aspirates was 11,665 pg/mL. Cytology was primarily helpful in excluding other diagnoses. Conclusion. Ultrasound guided FNA is a highly specific localization test for parathyroid tumors. This procedure can be successfully performed by surgeons in the office setting and is extremely valuable for directing parathyroid exploration in challenging cases. We recommend incorporating ultrasound and FNA as a pre-operative localization strategy for selected patients with HPT.

AB - Background. This study investigates the utility of ultrasound guided parathyroid fine needle aspiration (FNA) as a localizing technique in patients with hyperparathyroidism (HPT) undergoing re-operative neck surgery or with unusually appearing or ectopically located glands. Methods. Selected patients with HPT underwent surgeon-performed FNA with ultrasound guidance. Aspirate contents were sent for cytology and parathyroid hormone (PTH) levels. All patients subsequently underwent parathyroid exploration. Results. 54 patients underwent 57 ultrasound guided parathyroid biopsies. Indications for FNA included prior parathyroid (n = 29), thyroid (n = 11), or other neck surgery (n = 2), or unusual parathyroid appearance or location (n = 12). A true positive was defined as a site where the PTH aspirate was >40 pg/mL and a hypercellular gland was removed at surgery. Based on this, there were 44 true positives, 10 true negatives, and 3 false negatives; there were no false positives. The median PTH level in positive aspirates was 11,665 pg/mL. Cytology was primarily helpful in excluding other diagnoses. Conclusion. Ultrasound guided FNA is a highly specific localization test for parathyroid tumors. This procedure can be successfully performed by surgeons in the office setting and is extremely valuable for directing parathyroid exploration in challenging cases. We recommend incorporating ultrasound and FNA as a pre-operative localization strategy for selected patients with HPT.

UR - http://www.scopus.com/inward/record.url?scp=29144466523&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=29144466523&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2005.08.030

DO - 10.1016/j.surg.2005.08.030

M3 - Article

C2 - 16360402

AN - SCOPUS:29144466523

VL - 138

SP - 1143

EP - 1151

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 6

ER -