title: Preoperative localization and intraoperative parathyroid hormone assay in korean patients with primary hyperparathyroidism.
abstract: BACKGROUND
  The intraoperative parathyroid hormone (IOPTH) assay is widely used in patients with primary hyperparathyroidism (PHPT). We investigated the usefulness of the IOPTH assay in Korean patients with PHPT.
  
  
  METHODS
  We retrospectively reviewed the data of 33 patients with PHPT who underwent parathyroidectomy. Neck ultrasonography (US) and 99mTc-sestamibi scintigraphy (MIBI scan) were performed preoperatively and IOPTH assays were conducted.
  
  
  RESULTS
  The sensitivity of neck US and MIBI scans were 91% and 94%, respectively. A 50% decrease in parathyroid hormone (PTH) levels 10 minutes after excision of the parathyroid gland was obtained in 91% (30/33) of patients and operative success was achieved in 97% (32/33) of patients. The IOPTH assay was 91% true-positive, 3% true-negative, 0% false-positive, and 6% false-negative. The overall accuracy of the IOPTH assay was 94%. In five cases with discordant neck US and MIBI scan results, a sufficient decrease in IOPTH levels helped the surgeon confirm the complete excision of the parathyroid gland with no additional neck exploration.
  
  
  CONCLUSIONS
  The IOPTH assay is an accurate tool for localizing hyperfunctioning parathyroid glands and is helpful for evaluating cases with discordant neck US and MIBI scan results.
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Eirie
authors.initials: E
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Jung Mi
authors.initials: JM
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Seok Young
authors.initials: SY
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Gil Tae
authors.initials: GT
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Yun Hyi
authors.initials: YH
authors.lastname: Ku
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Hong Il
authors.initials: HI
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Myung Chul
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Guk Haeng
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea. chorong24@gmail.com.
authors.forename: Min Joo
authors.initials: MJ
authors.lastname: Kim
keywords: Hyperparathyroidism, primary; Parathyroid hormone; Parathyroid neoplasms; Technetium Tc 99m sestamibi; Ultrasonography