ArticleFrontiers in endocrinology2026
Preoperative localization in primary hyperparathyroidism: a stepwise approach integrating PTH-FNA washout and second-line
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Accurate preoperative localization of parathyroid adenomas is essential for the success of minimally invasive parathyroidectomy. This study evaluated the detection rate of parathyroid hormone assay on fine-needle aspiration washout and in conventional and advanced imaging modalities modeling a hypothetical stepwise diagnostic approach for primary hyperparathyroidism. Methods: We conducted a retrospective single-center study including 32 patients with primary hyperparathyroidism who underwent minimally invasive parathyroidectomy and preoperative parathyroid hormone assay on fine-needle aspiration washout. We used the PTH-FNA washout to serum PTH ratio as the cutoff: a value greater than 1 was considered indicative of positive localization, while a value equal to or less than 1 was considered negative. Preoperative localization procedures included ultrasonography, MIBI-Scan, and Results: Parathyroid hormone assay on fine-needle aspiration washout was positive in 20 of 32 patients (62.5%, 95% CI 45.3-77.1%). Among washout-positive patients, 7 of 20 (35.0%) underwent surgery based on ultrasonography and washout findings alone, with histological confirmation of parathyroid adenoma in all cases. In the washout-positive subgroup in whom MIBI-Scan was also performed, scintigraphy was diagnostic in 7 of 13 cases (53.8%). In washout-negative patients, scintigraphy localized the lesion in 6 of 12 cases (50.0%). In patients with non-localizing washout and scintigraphy findings, Conclusion: This retrospective, single-center,
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