title: Selective Venous Blood Sampling for Hyperparathyroidism with unclear Localization of the Parathyroid Gland.
abstract: Purpose:Evaluation of the benefit of selective venous blood sampling (SVS) for the preoperative identification of parathyroid adenomas with unclear localization in non-invasive diagnostics.Materials and Methods:In a retrospective study, all patients (n = 23) with primary (n = 21) or tertiary (n = 2) hyperparathyroidism were evaluated from 2005 to 2016 at the Hospital Nuremberg-North. These patients all received one (n = 20) or more (n = 3) SVS. 15 patients had one or more previous unsuccessful surgeries (group A), 8 patients received the SVS primarily before the first surgery (group B). Results of SVS were compared with the results of surgery, non-invasive diagnostic procedures and clinical follow up.Results:In 24 out of 26 SVS a significant PTH peak was found. 19 patients underwent surgery after SVS. In 16 of these cases (84 %) the SVS peak was concordant with the intraoperative localization. Thus, SVS of all operated patients had a sensitivity of 94 %. Considering only patients with prior HPT surgery the sensitivity was 89 %. In none of the 26 examinations complications occurred.Conclusion:Our results demonstrate that selective venous blood sampling SVS in cases with unclear imaging of parathyroid adenomas is an effective and low-risk invasive diagnostic method to localize parathyroid adenomas and helps to improve surgical therapy.Key points:• low risk invasive diagnostic procedure to localize parathyroid adenomas• additional step if non-invasive diagnostics are negative or inconclusive• high sensitivity in the detection of parathyroid adenomasCitation Format:• Hader C, Uder M, Loose RWR et al. Selective Venous Blood Sampling for Hyperparathyroidism with unclear Localization of the Parathyroid Gland. Fortschr Röntgenstr 2016; 188: 1144 - 1150.
authors.affiliation: Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, University Hospital, Erlangen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hader
authors.affiliation: Institute of Radiology, Friedrich-Alexander-University Erlangen-Nuremberg, University Hospital, Erlangen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Uder
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hospital Nuremberg North, Nuremberg, Germany.
authors.forename: R W R
authors.initials: RW
authors.lastname: Loose
authors.affiliation: Department for General, Visceral and Thoracic Surgery, Hospital Nuremberg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Linnemann
authors.affiliation: Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine - Central Laboratory, Hospital Nuremberg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Bertsch
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Hospital Nuremberg North, Nuremberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Adamus
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D010282:Parathyroid Neoplasms / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D018962:Phlebotomy / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014680:Veins / Q000000981:diagnostic imaging*