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Rapid Intra-operative Parathyroid Hormone Measurements

Developed in the 1990s, the rapid measurement of blood parathyroid hormone (PTH) levels has revolutionized the surgical treatment of hyperparathyroidism.

Using the Roche cobas analyzer, Memorial Healthcare System pathologists are able to rapidly measure (usually less than 10 minutes turnaround) blood PTH levels before and after parathyroid gland removal. If there is a greater than 50 percent reduction in the blood PTH concentration with removal of the abnormal gland, there is a very high likelihood of surgical cure and the physicians can stop searching for other enlarged glands. The PTH analysis takes eight minutes to complete and is highly accurate.

Without this test, minimally invasive radio-guided parathyroid surgery (MIRP) has been found to fail about 10 percent of the time. Ten percent of hyperparathyroidism patients have more than one enlarged parathyroid. Quite often, the extra abnormal glands are not recognized by preoperative Sestamibi scanning or the intra-operative Sestamibi-guided probe. The best way to recognize multiple abnormal glands in the operating room is by observing an inadequate drop in blood PTH levels after removal of the first abnormal gland.

Rapid turnaround PTH measurements help doctors maximize the chance for a successful minimally invasive radio-guided parathyroid surgery.



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