title: A five year audit of the role of parathyroid hormone assays and thallium-technetium isotope subtraction scanning in the preoperative investigation of primary hyperparathyroidism.
abstract: An audit has been performed of the value of parathyroid hormone assays and thallium-technetium isotope scanning in the pre-operative investigation of 67 hypercalcaemic patients referred for surgery over a 5 year period. Parathyroid hormone assay by region-specific technique was found to have a diagnostic sensitivity of 75% (n = 52) whilst the more recent assay for the intact molecule was 97% sensitive (n = 34). Thallium-technetium isotope scanning was only 64% sensitive overall (n = 59), due in part to the small size of adenomata now being referred for surgery. This study confirms the role of the intact parathyroid hormone assay but questions that of thallium-technetium isotope scanning in standard protocols of investigation for hypercalcaemia.
authors.affiliation: Department of Surgery, Northwick Park Hospital, Harrow, Middlesex, UK.
authors.forename: J I
authors.initials: JI
authors.lastname: Livingstone
authors.forename: M
authors.initials: M
authors.lastname: Tellez
authors.forename: M
authors.initials: M
authors.lastname: Burke
authors.forename: P J
authors.initials: PJ
authors.lastname: Ashby
authors.forename: M G
authors.initials: MG
authors.lastname: Rinsler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011300:Preoperative Care / Q000379:methods*; D013382:Subtraction Technique; D013667:Technetium; D013794:Thallium Radioisotopes
chemical_list: D010281:Parathyroid Hormone; D013794:Thallium Radioisotopes; D013667:Technetium