Findings of pilot study following the implementation of point of care intraoperative PTH assay using whole blood during surgery for primary hyperparathyroidism

Frontiers in Endocrinology

Endocrinology

Mesfin Senbeto¹  Arslan Pannu¹  Emily Metcalfe¹  Saba P. Balasubramanian²  Rahul Mohan Kumar² 

[1] Sheffield Endocrine Surgery Unit, Sheffield Teaching Hospitals, Sheffield, United Kingdom;Sheffield Endocrine Surgery Unit, Sheffield Teaching Hospitals, Sheffield, United Kingdom;School of Medicine and Biomedical Sciences, University of Sheffield, Sheffield, United Kingdom;

关键词: parathyroid hormone (PTH);    Intraoperative PTH (IOPTH);    parathyroidectomy;    NBCL CONNECT;    point of care (POC);   

DOI  :  10.3389/fendo.2023.1198894

 received in 2023-04-02, accepted in 2023-08-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo report findings of pilot study using a novel point of care (POC) intraoperative parathyroid hormone (IOPTH) assay for parathyroid hormone (PTH) using whole blood during surgery for primary hyperparathyroidism (PHPT).MethodsPatients undergoing surgery for primary hyperparathyroidism from March to November 2022 where intraoperative PTH assay was performed using the NBCL CONNECT IOPTH and the laboratory PTH assay were included (group 1). The biochemistry results were reviewed to determine concordance between NBCL and lab PTH values and diagnostic test parameters of the NBCL CONNECT assay. ‘In-theatre’ times were then compared with a historical cohort (group 2) where the lab-based IOPTH assay alone was used.ResultsOf the 141 paired samples in group I, correlation between NBCL and the lab assay was high (rho=0.82; p<0.001). PTH levels using the NBCL assay dropped satisfactorily (>50% of the basal or 0 min sample; whichever was lower – i.e. positive test) in 23 patients; giving a positive predictive value of 100%. Of the 9 patients that did not demonstrate a drop, two were true negative (negative predictive value of 22%) leading to cure after excision of another gland. Group 1 (150 mins) had a significantly shorter ‘in-theatre’ time compared to group 2 (167 mins) (p=0.007); despite much higher use of near infra-red autofluorescence (NIRAF) (72% vs 11.6% in group I and 2 respectively).ConclusionThe NBCL CONNECT POC IOPTH assay gives comparable results to lab based PTH assays and can be performed without need for a centrifuge or qualified technicians. Surgeons, however, need to be aware of the potential for false-negative results.

【 授权许可】

Unknown   
Copyright © 2023 Mohan Kumar, Pannu, Metcalfe, Senbeto and Balasubramanian