caa a22 4500 445335181 CHVBK 20180317142752.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1375-7 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1375-7 Changing Intraoperative Parathyroid Hormone Collection Sites from Peripheral to Central Does Not Affect Predictive Accuracy during Minimally Invasive Parathyroidectomy [Elektronische Daten] [Sherif Abdel-Misih, James Broome, Xiaobai Li, David Arrese, J. Kenneth Jacobs, Eugene Chambers, John Phay] Background: Intraoperative parathyroid hormone (ioPTH) monitoring (IPM) is vital to minimally invasive parathyroidectomy. Techniques vary in assay sampling, potentially affecting predictive accuracy of operative success. Initial guidelines were established using peripheral sites, but central sites may be preferred or necessary when peripheral access is not feasible. We hypothesize that changing collection sites from preexcision peripheral sites to postexcision central sites would not affect IPM accuracy. Methods: Analysis of 64 consecutive patients who underwent parathyroidectomy for primary hyperparathyroidism was undertaken. PTH assays were collected simultaneously from a peripheral vein (PV) and central vein (CV) preexcision and at a 10-min interval after initial parathyroid excision. IPM success was defined as PTH decrease ≥50% 10min after initial excision. Predictive accuracy was determined by the need to resect another abnormal gland and biochemical normalization in the postoperative clinic. Receiver operating characteristic (ROC) method with area under the curve (AUC) compared diagnostic accuracy of different assay approaches. Results: Centrally, a statistically higher mean pre- and postexcision ioPTH of 391pg/ml and 58pg/ml was found compared with peripheral means of 156pg/ml and 49pg/ml, respectively (p<0.001). The AUC when changing from a PV preexcision to a CV postexcision ioPTH was 0.89, comparable to AUC for peripheral or central assay collections alone (AUC=0.83 and 0.85, respectively). Conclusions: This study suggests that altering collection sites does not alter assay validity. In cases where peripheral sampling is compromised, changing from a peripheral to central sites will not likely alter the predictive accuracy of IPM significantly. Society of Surgical Oncology, 2010 Abdel-Misih Sherif Division of Surgical Oncology, The Ohio State University Medical Center/James Cancer Hospital, Columbus, OH, USA aut Broome James Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Nashville, TN, USA aut Li Xiaobai Center of Biostatistics, The Ohio State University Medical Center, Columbus, OH, USA aut Arrese David Division of Surgical Oncology, The Ohio State University Medical Center/James Cancer Hospital, Columbus, OH, USA aut Kenneth Jacobs J. Vanderbilt University Medical School, Nashville, TN, USA aut Chambers Eugene Department of Surgery, Nashville Veterans Affairs Medical Center, Nashville, TN, USA aut Phay John Division of Surgical Oncology, The Ohio State University Medical Center/James Cancer Hospital, Columbus, OH, USA aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 771-776 1068-9265 18:3<771 2011 18 10434 https://doi.org/10.1245/s10434-010-1375-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1375-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abdel-Misih Sherif Division of Surgical Oncology, The Ohio State University Medical Center/James Cancer Hospital, Columbus, OH, USA aut NATIONALLICENCE 700 1- Broome James Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, Nashville, TN, USA aut NATIONALLICENCE 700 1- Li Xiaobai Center of Biostatistics, The Ohio State University Medical Center, Columbus, OH, USA aut NATIONALLICENCE 700 1- Arrese David Division of Surgical Oncology, The Ohio State University Medical Center/James Cancer Hospital, Columbus, OH, USA aut NATIONALLICENCE 700 1- Kenneth Jacobs J. Vanderbilt University Medical School, Nashville, TN, USA aut NATIONALLICENCE 700 1- Chambers Eugene Department of Surgery, Nashville Veterans Affairs Medical Center, Nashville, TN, USA aut NATIONALLICENCE 700 1- Phay John Division of Surgical Oncology, The Ohio State University Medical Center/James Cancer Hospital, Columbus, OH, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 771-776 1068-9265 18:3<771 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer