title: Hormone, relationships of parathyroid gamma counts, and adenoma mass in minimally invasive parathyroidectomy.
abstract: OBJECTIVE
  To better understand relationships of parathyroid hormone (PTH) production, adenoma gamma counts, and adenoma mass in patients undergoing minimally radioguided invasive parathyroidectomy for primary hyperparathyroidism from single-gland disease.
  
  
  METHODS
  A prospective review of 104 patients operated on by a single surgeon.
  
  
  METHODS
  University tertiary hospital.
  
  
  METHODS
  Adults who have primary hyperparathyroidism due to a single gland.
  
  
  RESULTS
  There were 23 men and 81 women with an average age of 63 years. The mean (SD) adenoma mass was 0.78 (0.69) g (median, 0.57 g). The mean (SD) percent of background for the adenoma was 120.2 (90.5). Preoperative PTH and percent of background gamma count of the adenoma showed a likely correlation with a Spearman ρ value of 0.2039 and a P value of .037. There were significant correlations between both percent of background of the adenoma and adenoma mass (Spearman ρ = 0.4991 and P < .0001). Preoperative PTH and adenoma mass also showed a significant positive correlation (Spearman ρ = 0.308 and P = .002).
  
  
  CONCLUSIONS
  There exist correlations between gland mass, radioactivity, and PTH level. Adenoma radiation counts do not appear to be a proxy for changes in PTH levels measured during surgery as has been reported. Intraoperative PTH has been shown by others not to be necessary when doing radioguided parathyroid surgery if the Norman rule is observed. However, a radioguided technique and intraoperative PTH can provide complementary information in making an assessment of completion of parathyroid procedures.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. bstack@uams.edu
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Stack
authors.forename: Evan R
authors.initials: ER
authors.lastname: Moore
authors.forename: Ryan H
authors.initials: RH
authors.lastname: Belcher
authors.forename: Horace J
authors.initials: HJ
authors.lastname: Spencer
authors.forename: Donald L
authors.initials: DL
authors.lastname: Bodenner
mesh_terms: D000236:Adenoma / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods*; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013667:Technetium; D047368:Tumor Burden
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D013667:Technetium